ADVENTIST BOLINGBROOK HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ADVENTIST BOLINGBROOK HOSPITAL (EIN 65-1219504)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-03
- IRS object ID
- 202233079349301763
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-03T10:31:22-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 651219504 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVENTIST BOLINGBROOK HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADVE | BusinessNameControlTxt |
| Phone | 6303125000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 REMINGTON BLVD | AddressLine1Txt |
| City | BOLINGBROOK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60440 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LYNN C ADDISCOTT | PersonNm |
| Person Title | ASSISTANT SECRETARY | PersonTitleTxt |
| Phone | 4073572317 | PhoneNum |
| Signature | 2022-11-01 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LYNN | PersonFirstNm |
| Person Last | ADDISCOTT | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVENTHEALTH BOLINGBROOK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ED NOSEWORTHY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 REMINGTON BLVD | AddressLine1Txt |
| City | BOLINGBROOK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60440 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $216,065,202 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ADVENTHEALTH.COM/HOSPITAL/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A 138-BED ACUTE-CARE HOSPITAL SERVING RESIDENTS IN & AROUND BOLINGBROOK, IL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 890 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $102,010 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,835,263 | PYContributionsGrantsAmt |
| CY Contributions Grants | $193,494 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $177,176,366 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $214,372,458 | CYProgramServiceRevenueAmt |
| PY Investment Income | $707,707 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,499,250 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $179,719,336 | PYTotalRevenueAmt |
| CY Total Revenue | $216,065,202 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $68,851 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $56,029 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $50,227,559 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $52,869,675 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $123,392,894 | PYOtherExpensesAmt |
| CY Other Expenses | $141,936,744 | CYOtherExpensesAmt |
| PY Total Expenses | $173,689,304 | PYTotalExpensesAmt |
| CY Total Expenses | $194,862,448 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,030,032 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $21,202,754 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $140,783,483 | TotalAssetsBOYAmt |
| Total Assets EOY | $157,968,235 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $123,884,513 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $122,619,377 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,898,970 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,348,858 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION AND ALL ITS SUBSIDIARY ORGANIZATIONS WERE ESTABLISHED BY THE SEVENTH-DAY ADVENTIST CHURCH TO BRING A MINISTRY OF HEALING AND HEALTH TO THE COMMUNITIES SERVED. OUR MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST.THE HOSPITAL AND HEALTHCARE SYSTEM WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION IS KNOWN AS ADVENTHEALTH. ADVENTHEALTH SEEKS TO BE WIDELY RESPECTED AS A CONSUMER-FOCUSED ORGANIZATION THAT ENGAGES INDIVIDUALS IN THEIR HEALTH BY DELIVERING WHOLISTIC, BEST PRACTICE CARE ACROSS A CONNECTED, COMPREHENSIVE CONTINUUM OF SERVICES. WITH CHRIST AS OUR EXAMPLE, ADVENTHEALTH CARES FOR AND NURTURES PEOPLE: OUR EMPLOYEES, OUR COMMUNITIES, OUR HEALTHCARE PROFESSIONALS, AND THOSE WHO TRUST US FOR CARE AND HEALING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $176,364,286 | ExpenseAmt |
| Grant | $56,029 | GrantAmt |
| Revenue | $214,270,448 | RevenueAmt |
| Desc | THE FILING ORGANIZATION DOES BUSINESS UNDER THE NAME AMITA HEALTH ADVENTIST MEDICAL CENTER BOLINGBROOK (AMITA HEALTH BOLINGBROOK, OR THE HOSPITAL). AMITA HEALTH BOLINGBROOK, WHICH IS PART OF ADVENTHEALTH, OPERATES A 138-BED ACUTE-CARE HOSPITAL IN BOLINGBROOK, ILLINOIS, THAT HAS SERVED THE HEALTHCARE NEEDS OF THE BOLINGBROOK COMMUNITY AND SURROUNDING AREAS SINCE THE HOSPITAL OPENED IN 2008. LOCATED AT 500 REMINGTON BLVD., AMITA HEALTH BOLINGBROOK IS A FULL-SERVICE HOSPITAL THAT INCLUDES TWO MEDICAL OFFICE BUILDINGS ON ITS CAMPUS IN BOLINGBROOK, AN AMBULATORY-CARE SITE IN PLAINFIELD, ILLINOIS, AND SEVEN OUTPATIENT PHYSICAL REHABILITATION SITES IN PARTNERSHIP WITH PT SOLUTIONS. SPECIALTY CARE AND OTHER SERVICES AVAILABLE AT THE HOSPITAL INCLUDE BARIATRICS, A BREAST CENTER, CANCER CARE, CARDIAC CARE, A CHRONIC DISEASE CENTER, EMERGENCY SERVICES, EXECUTIVE HEALTH, GASTROENTEROLOGY, GERIATRICS, HOME HEALTH, HOSPICE, INTERVENTIONAL RADIOLOGY, NEUROLOGY, A PAIN MANAGEMENT CENTER, PEDIATRICS, PHYSICAL REHABILITATION, RADIOLOGY, SLEEP DISORDERS, SURGICAL SERVICES, AND WOMEN'S CARE. IN 2015, THE HOSPITAL OPENED A 24-BED GEROPSYCHIATRY UNIT TO ADDRESS A GROWING COMMUNITY NEED FOR MENTAL HEALTH TREATMENT FOR OLDER ADULTS. IN 2017, AMITA HEALTH BOLINGBROOK OPENED A HEPATITIS-C CLINIC DEDICATED TO THE DIAGNOSIS AND TREATMENT OF THE DISEASE, WHICH KILLS TENS OF THOUSANDS OF PEOPLE A YEAR. THE HOSPITAL HAS EXPANDED ITS OUTPATIENT SERVICES STEADILY IN RECENT YEARS, OFFERING OUTPATIENT SERVICES SUCH AS BARIATRIC SURGERY, INTERVENTIONAL PAIN MANAGEMENT, AND A MOBILE PET/CT SERVICE. THE HOSPITAL'S AMBULATORY-CARE SITE IN PLAINFIELD, ILLINOIS, OFFERS IMAGING, LABORATORY AND REHABILITATION SERVICES. AMITA HEALTH BOLINGBROOK PLAYS AN ACTIVE ROLE IN THE COMMUNITY, SPONSORING A WIDE VARIETY OF COMMUNITY OUTREACH PROGRAMS, INCLUDING FREE HEALTH SCREENINGS AND EDUCATIONAL PROGRAMS. IN ADDITION, THE HOSPITAL PROVIDES HEALTH SERVICES TO LOCAL EMPLOYERS.AMITA HEALTH BOLINGBROOK HAS BUILT A REPUTATION FOR CLINICAL EXCELLENCE, EARNING RECOGNITION FROM SEVERAL INDEPENDENT AUTHORITIES. THE JOINT COMMISSION HAS ACCREDITED THE HOSPITAL WITH THE GOLD SEAL OF APPROVAL FOR QUALITY. THE JOINT COMMISSION AND THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION HAVE CERTIFIED THE HOSPITAL AS A PRIMARY STROKE CENTER. THE BLUE CROSS BLUE SHIELD ASSOCIATION HAS RECOGNIZED THE MEDICAL CENTER AS A BLUE DISTINCTION CENTER+ FOR DELIVERING SAFE, HIGH-QUALITY AND COST-EFFICIENT MATERNITY CARE. THE HOSPITAL'S WOMEN'S IMAGING CENTER HAS BEEN DESIGNATED BY THE AMERICAN COLLEGE OF RADIOLOGY AS A BREAST IMAGING CENTER OF EXCELLENCE, AND ITS SLEEP DISORDERS CENTER HAS BEEN ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE. IN 2021, AMITA HEALTH BOLINGBROOK TREATED 5,724 INPATIENTS, PERFORMED 961 INPATIENT SURGERIES AND DELIVERED 630 BABIES. THE HOSPITAL'S MEDICAL STAFF INCLUDES APPROXIMATELY 480 PHYSICIANS REPRESENTING 47 MEDICAL AND SURGICAL SPECIALTIES.AMITA HEALTH BOLINGBROOK PROVIDES CARE FOR ALL, INCLUDING THE FINANCIALLY DISADVANTAGED, UNINSURED, UNDERINSURED, HOMELESS AND THOSE WHO RECEIVE PUBLIC AID. IN 2021, THE HOSPITAL PROVIDED $4,534,256 OF CHARITY CARE AT COST. THIS WAS IN ADDITION TO $147,003 IN OTHER COMMUNITY BENEFITS SERVICES, AND $8,094,812 OF UNREIMBURSED MEDICAID AT COST.ABOUT ADVENTIST MIDWEST HEALTHAMITA HEALTH BOLINGBROOK IS A SUBSIDIARY ORGANIZATION OF ADVENTIST MIDWEST HEALTH (AMH), A NETWORK OF FOUR NOT-FOR-PROFIT HOSPITALS AND THEIR OUTPATIENT-BASED HEALTHCARE FACILITIES IN CHICAGO'S WESTERN SUBURBS. AMH TAKES A HOLISTIC APPROACH TO WELLNESS, ADDRESSING THE PHYSICAL, MENTAL, SOCIAL AND SPIRITUAL NEEDS OF THE PEOPLE IT SERVES. AMH'S HOSPITALS AND OTHER FACILITIES ARE INTEGRAL TO THE FABRIC OF THEIR COMMUNITIES. AMH PARTNERS WITH LOCAL CIVIC ORGANIZATIONS AND BUSINESSES TO BRING STATE-OF-THE-ART TREATMENTS AND PREVENTIVE HEALTHCARE SERVICES CLOSE TO WHERE PEOPLE LIVE AND WORK. AS PART OF ADVENTHEALTH, THE LARGEST, NOT-FOR-PROFIT PROTESTANT HOSPITAL SYSTEM IN THE NATION, AMH IS GROUNDED IN CHRISTIAN VALUES AND COMMITTED TO EXTENDING THE HEALING MINISTRY OF CHRIST. AMH WELCOMES PATIENTS FROM ANY RELIGIOUS DENOMINATION AS WELL AS PATIENTS WHO DO NOT ASCRIBE TO ANY RELIGION.IN FEBRUARY 2015, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (ABHS) FORMED A JOINT OPERATING COMPANY (JOC). A JOC ALLOWS SEPARATE OWNERS TO INTEGRATE OPERATIONS TO ACHIEVE A COMMON GOAL WHILE MAINTAINING SEPARATE OWNERSHIP OF ASSETS. IT ALSO ALLOWS AMH AND ABHS TO WORK IN UNISON WHILE PRESERVING THE ADVENTIST AND CATHOLIC IDENTITIES AND MISSION PRIORITIES THAT DEFINE AMH AND ABHS, RESPECTIVELY. IN APRIL 2015, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO., D/B/A AMITA HEALTH, WAS ANNOUNCED AS THE NEW NAME OF THE JOC. THE NAME AMITA IS INSPIRED BY THE MEANING IT HAS IN SEVERAL LANGUAGES -- FRIENDSHIP IN ITALIAN, HONESTY AND TRUTH IN HEBREW, AND SPIRITUAL LIGHT AND BOUNDLESSNESS IN HINDI. THE NAME REFLECTS AMITA HEALTH'S FAITH-BASED CALL TO HEALING, ITS CORE VALUES, AND THE COMPASSION AND DEDICATION THAT ITS CAREGIVERS SHOW EVERY DAY TO PATIENTS, THEIR FAMILIES AND EACH OTHER.AMITA HEALTH BOLINGBROOK SERVICES DIAGNOSTIC SERVICESTHE HOSPITAL'S DIAGNOSTIC SERVICES INCLUDE THE LATEST TECHNOLOGY AND PRACTICES, WHICH ARE ACCREDITED BY NATIONALLY AND STATE RECOGNIZED AGENCIES AND ASSOCIATIONS, SUCH AS THE ILLINOIS EMERGENCY MANAGEMENT AGENCY, THE AMERICAN COLLEGE OF RADIOLOGY, THE COLLEGE OF AMERICAN PATHOLOGISTS, THE CLINICAL LABORATORY IMPROVEMENT AMENDMENTS AND THE JOINT COMMISSION.DIAGNOSTIC SERVICES OFFERED INCLUDE: -- DIAGNOSTIC IMAGING (GENERAL X-RAY, CT, MRI [INCLUDING OPEN MRI], PET, ULTRASOUND, NUCLEAR MEDICINE)-- BREAST-CARE SERVICES (SCREENING AND 3-D DIAGNOSTIC MAMMOGRAPHY, BREAST BIOPSY ULTRASOUND, STEREOTACTIC BREAST BIOPSY, BONE DENSITOMETRY, GENETIC COUNSELING) -- CARDIOLOGY (CARDIAC CATHETERIZATION, ELECTROPHYSIOLOGY, ELECTROCARDIOGRAMS [EKGS], STRESS TESTING, ECHOCARDIOGRAPHY, HOLTER MONITORING OF ARRHYTHMIAS)-- PULMONARY DIAGNOSTICS (ARTERIAL BLOOD GAS ANALYSIS)-- GASTROENTEROLOGY (COLONOSCOPY, BRONCHOSCOPY)-- LABORATORY/PATHOLOGY (CHEMISTRY, MICROBIOLOGY, HEMATOLOGY, HISTOLOGY, CYTOLOGY, PHLEBOTOMY, TRANSFUSION SERVICES)EMERGENCY DEPARTMENTEMERGENCY MEDICAL CARE IS PROVIDED 24/7 FOR ALL AGES AND TYPES OF PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES.OUTPATIENT SERVICES PERFORMED IN 2021: -- 2,618 OUTPATIENT SURGERIES-- 32,516 EMERGENCY ROOM VISITS. | Desc |
| Total Program Service Expenses | $176,364,286 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 890 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JARED BROWN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2242730191 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 REMINGTON BLVD | AddressLine1Txt |
| City | BOLINGBROOK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60440 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Key EmployeeKeyEmployeeInd | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HAFFNER PHD RANDALL | ||||||||||
| DIR/CHAIRMAN (END 2/21) | 0.30 | 50.00 | Yes (X) | $0 | $3,620,109 | $209,173 | ||||
| SNYDER BRENT | ||||||||||
| DIRECTOR | 0.30 | 50.00 | Yes (X) | $0 | $1,786,890 | $41,385 | ||||
| BACON KENNETH | ||||||||||
| DIR/CHAIRMAN (BEG 3/21) | 0.30 | 50.00 | Yes (X) | $0 | $1,078,033 | $201,962 | ||||
| THORDARSON THOR | ||||||||||
| DIR/PRES/SEC/EVP & COO | 0.30 | 50.00 | Yes (X) | $0 | $1,157,707 | $36,164 | ||||
| MURRILL MICHAEL | ||||||||||
| FORMER COO | 0.00 | 50.00 | $0 | $700,614 | $160,963 | Yes (X) | ||||
| BUCHANAN HERBERT | ||||||||||
| DIRECTOR | 5.00 | 45.00 | Yes (X) | $72,408 | $651,670 | $73,664 | ||||
| CARROLL MD RICHARD | ||||||||||
| VP/CMO BOLINGBROOK/GLENOAK | 25.00 | 25.00 | $0 | $690,386 | $37,562 | Yes (X) | ||||
| CHRISTIAN BRUCE | ||||||||||
| PRES/CEO BOLINGBROOK/GLENO | 25.00 | 25.00 | $0 | $599,233 | $37,840 | Yes (X) | ||||
| ROEHR RICHARD | ||||||||||
| FORMER COO | 0.00 | 50.00 | $0 | $518,664 | $49,402 | Yes (X) | ||||
| MURPHY MARY | ||||||||||
| FORMER REGIONAL CNO | 0.00 | 50.00 | $0 | $497,136 | $29,880 | Yes (X) | ||||
| RADIVOJEVIC VLADIMIR | ||||||||||
| VP/COO BOLINGBROOK/GLENOAK | 25.00 | 25.00 | $0 | $323,556 | $46,099 | Yes (X) | ||||
| PAWLIK RN COLLEEN | ||||||||||
| INTERIM CNO BOLING/GLEN (BEG 4/21) | 25.00 | 25.00 | $0 | $271,476 | $31,966 | Yes (X) | ||||
| BROWN JARED | ||||||||||
| SR. DIR. FINANCE-BOLINGBRO | 25.00 | 25.00 | $0 | $243,374 | $32,101 | Yes (X) | ||||
| CRUZ RN OBED | ||||||||||
| VP/CNO BOLINGBROOK (END 4/21) | 50.00 | 0.00 | $0 | $233,724 | $10,277 | Yes (X) | ||||
| PAMINTUAN JAY | ||||||||||
| RN-CHARGE | 55.00 | 0.00 | $192,329 | $0 | $34,588 | Yes (X) | ||||
| DE RAMOS DO DAVID | ||||||||||
| DIRECTOR | 0.30 | 50.00 | Yes (X) | $0 | $193,684 | $28,847 | ||||
| LEONARD DIANE | ||||||||||
| RN DIR-NURSING | 60.00 | 0.00 | $185,007 | $0 | $27,653 | Yes (X) | ||||
| ALBAUGH JOLENE | ||||||||||
| FORMER CNO | 0.00 | 50.00 | $0 | $177,325 | $19,676 | Yes (X) | ||||
| SADURSKI AGNES | ||||||||||
| RN EMERGENCY DEPT | 50.00 | 0.00 | $155,881 | $0 | $9,342 | Yes (X) | ||||
| PONTERIO JODI | ||||||||||
| MGR-PHARMACY | 50.00 | 0.00 | $154,064 | $0 | $10,507 | Yes (X) | ||||
| MICHALOWICZ CATHERINE | ||||||||||
| RN MGR-OPERATING ROOM | 50.00 | 0.00 | $158,649 | $0 | $5,497 | Yes (X) | ||||
| GUTH MD SCOTT | ||||||||||
| DIRECTOR | 0.30 | 8.70 | Yes (X) | $0 | $62,213 | $0 | ||||
| MARTINEZ MD CARLOS | ||||||||||
| DIRECTOR | 4.10 | 0.06 | Yes (X) | $29,219 | $0 | $0 | ||||
| SCOTT GLYNN | ||||||||||
| DIRECTOR | 0.30 | 3.70 | Yes (X) | $0 | $4,602 | $0 | ||||
| AGUILERA RONALD | ||||||||||
| DIRECTOR | 0.30 | 3.70 | Yes (X) | $0 | $4,602 | $0 | ||||
| DENSLOW KENNETH | ||||||||||
| DIRECTOR/VICE CHAIR (BEG 6/21) | 0.30 | 3.70 | Yes (X) | $0 | $4,402 | $0 | ||||
| VALENTINE II MDIV MAURICE | ||||||||||
| DIRECTOR/VICE CHAIR (END 4/21) | 0.30 | 3.70 | Yes (X) | $0 | $4,200 | $0 | ||||
| MURREY MD SUSAN | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| ARQUILLA VENANZIO | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| EASTMAN LINDA | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| GRAY JR MARSHALL | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| HAWKINS RONNIE | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| HOLDER BILL | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| O'CONNOR PETER | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| WRIGHT JONATHAN | ||||||||||
| DIRECTOR | 0.30 | 0.60 | Yes (X) | $0 | $0 | $0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $947,557 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $12,823,600 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,134,548 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 61 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| R1 RCM INC | |||||
| 39918 TREASURY CENTER | CHICAGO | IL | 60694 | REVENUE CYCLE SERVICES | $7,250,213 |
| ALVERNO CLINICAL LABORATORIES LLC | |||||
| 2434 INTERSTATE PLAZA DRIVE | HAMMOND | IN | 46324 | LAB SERVICES | $6,200,477 |
| PT SOLUTIONS HOLDINGS LLC | |||||
| PO BOX 441146 | KENNESAW | GA | 30160 | THERAPY SERVICES | $5,582,645 |
| COMPASS GROUP USA INC | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD & ENVIRONMENTAL SERVICES | $4,319,197 |
| TRIMEDX LLC | |||||
| PO BOX 636129 | CINCINNATI | OH | 45263 | BIOMED CLINICAL SERVICES | $1,069,990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $129,703 | RelatedOrganizationsAmt |
| Government Grants | $63,791 | GovernmentGrantsAmt |
| Total Contributions | $193,494 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $197,252,966 | $197,252,966 | |
| PHARMACY | 622110 | $16,146,418 | $16,052,390 | $94,028 |
| HEALTH EDUCATION PROGRAMS | 622110 | $374,899 | $374,899 | |
| CAFETERIA REVENUE | 622110 | $346,708 | $346,708 | |
| MEDICAL OFFICE BUILDING | 622110 | $104,152 | $104,152 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $147,315 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $139,333 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $7,982 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $214,372,458 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $715,327 | TotalRevenueColumnAmt |
| Exclusion | $715,327 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $781,136 | SecuritiesAmt |
| Other | $2,787 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $781,136 | SecuritiesAmt |
| Other | $2,787 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $783,923 | TotalRevenueColumnAmt |
| Exclusion | $783,923 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $216,065,202 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $214,270,448 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $102,010 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,499,250 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,029 | TotalAmt |
| Program Services | $56,029 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,442,115 | TotalAmt |
| Management And General | $1,442,115 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,367,956 | TotalAmt |
| Program Services | $36,772,262 | ProgramServicesAmt |
| Management And General | $2,595,694 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,524,960 | TotalAmt |
| Program Services | $1,381,237 | ProgramServicesAmt |
| Management And General | $143,723 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,325,039 | TotalAmt |
| Program Services | $6,727,556 | ProgramServicesAmt |
| Management And General | $597,483 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,209,605 | TotalAmt |
| Program Services | $2,907,109 | ProgramServicesAmt |
| Management And General | $302,496 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,507 | TotalAmt |
| Management And General | $56,507 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,176 | TotalAmt |
| Management And General | $61,176 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,205,202 | TotalAmt |
| Program Services | $42,823,872 | ProgramServicesAmt |
| Management And General | $12,381,330 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,538 | TotalAmt |
| Management And General | $51,538 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,426,382 | TotalAmt |
| Program Services | $11,177,253 | ProgramServicesAmt |
| Management And General | $249,129 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,194,754 | TotalAmt |
| Program Services | $5,595,670 | ProgramServicesAmt |
| Management And General | $599,084 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,118,386 | TotalAmt |
| Program Services | $3,118,386 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,966 | TotalAmt |
| Management And General | $19,966 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,317 | TotalAmt |
| Program Services | $38,317 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,936,883 | TotalAmt |
| Program Services | $1,936,883 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,777,792 | TotalAmt |
| Program Services | $5,777,792 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,923,971 | TotalAmt |
| Program Services | $2,907,171 | ProgramServicesAmt |
| Management And General | $16,800 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $46,038,238 | $46,038,238 | |
| STATE TAX INDIGENT ASSE | $7,682,238 | $7,682,238 | |
| REPAIRS & MAINTENANCE | $1,266,396 | $1,266,396 | |
| UBI TAXES | -$28,970 | -$28,970 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,968 | TotalAmt |
| Program Services | $157,877 | ProgramServicesAmt |
| Management And General | $10,091 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,862,448 | TotalAmt |
| Program Services | $176,364,286 | ProgramServicesAmt |
| Management And General | $18,498,162 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,445 | BOYAmt |
| EOY | $3,528 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,570,075 | BOYAmt |
| EOY | $45,995,171 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,471,618 | BOYAmt |
| EOY | $26,840,685 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,295,910 | BOYAmt |
| EOY | $2,993,401 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,512,764 | BOYAmt |
| EOY | $2,062,982 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $181,410,412 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $110,010,465 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,715,016 | BOYAmt |
| EOY | $71,399,947 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $339,473 | BOYAmt |
| EOY | $294,795 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,875,182 | BOYAmt |
| EOY | $8,377,726 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,783,483 | BOYAmt |
| EOY | $157,968,235 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,615,638 | BOYAmt |
| EOY | $8,699,330 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,012 | BOYAmt |
| EOY | $439,753 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,809,863 | BOYAmt |
| EOY | $113,480,294 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,884,513 | BOYAmt |
| EOY | $122,619,377 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,559,139 | BOYAmt |
| EOY | $35,089,600 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $339,831 | BOYAmt |
| EOY | $259,258 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,898,970 | BOYAmt |
| EOY | $35,348,858 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,783,483 | BOYAmt |
| EOY | $157,968,235 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $21,202,754 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $557,417 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$3,310,283 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $750 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $28,901 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $29,651 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND ILLINOIS HOSPITAL ASSOCIATION, AND $750 TO WILL COUNTY CENTER FOR ECONOMIC DEVELOPMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $109,515,765 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,676,206 | DepreciationAmt |
| Book Value | $60,839,559 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,742,085 | OtherCostOrOtherBasisAmt |
| Depreciation | $61,099,096 | DepreciationAmt |
| Book Value | $9,642,989 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,152,562 | OtherCostOrOtherBasisAmt |
| Depreciation | $235,163 | DepreciationAmt |
| Book Value | $917,399 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $71,399,947 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM RELATED | $1,862,235 |
| OTHER RECEIVABLES | $2,208,296 |
| OTHER ASSETS | $138,495 |
| RECEIVABLE FROM THIRD PARTIES | $3,226,697 |
| RIGHT OF USE ASSET - OPERATING LEASE | $942,003 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,377,726 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED | $9,792,597 |
| PAYABLE TO THIRD PARTIES | $17,899,319 |
| AR CREDIT BALANCES | $1,646,184 |
| ACCRUED INTEREST PAYABLE | $13 |
| INTERCO ALLOC OF TE BOND PROCEEDS | $80,785,455 |
| OPERATING LEASE LIABILITY | $960,010 |
| OTHER LIABILITIES | $2,396,716 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $113,480,294 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FILING ORGANIZATION IS A SUBSIDIARY ORGANIZATION WITHIN ADVENTHEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH CONTAIN THE FOLLOWING FIN 48 (ASC 740) FOOTNOTE: PLEASE NOTE THAT DOLLAR AMOUNTS ARE IN THOUSANDS. HEALTHCARE CORPORATION AND ITS AFFILIATED ORGANIZATIONS, OTHER THAN NORTH AMERICAN HEALTH SERVICES, INC. AND ITS SUBSIDIARY (NAHS), ARE EXEMPT FROM STATE AND FEDERAL INCOME TAXES. ACCORDINGLY, HEALTHCARE CORPORATION AND ITS TAX-EXEMPT AFFILIATES ARE NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES EXCEPT FOR ANY NET UNRELATED BUSINESS TAXABLE INCOME. NAHS IS A WHOLLY OWNED, FOR-PROFIT SUBSIDIARY OF HEALTHCARE CORPORATION. NAHS AND ITS SUBSIDIARY ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. NAHS FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN AND, WHERE APPROPRIATE, CONSOLIDATED STATE INCOME TAX RETURNS. ALL TAXABLE INCOME WAS FULLY OFFSET BY NET OPERATING LOSS CARRYFORWARDS FOR FEDERAL INCOME TAX PURPOSES; AS SUCH, THERE IS NO PROVISION FOR CURRENT FEDERAL OR STATE INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020. NAHS ALSO HAS TEMPORARY DEDUCTIBLE DIFFERENCES OF APPROXIMATELY $33,000 AND $41,800 AT DECEMBER 31, 2021 AND 2020, RESPECTIVELY, PRIMARILY AS A RESULT OF NET OPERATING LOSS CARRYFORWARDS. AT DECEMBER 31, 2021, NAHS HAD NET OPERATING LOSS CARRYFORWARDS OF APPROXIMATELY $34,000, EXPIRING BEGINNING IN 2022 THROUGH 2026. DEFERRED TAXES HAVE BEEN PROVIDED FOR THESE AMOUNTS, RESULTING IN A NET DEFERRED TAX ASSET OF APPROXIMATELY $8,100 AND $10,200 AT DECEMBER 31, 2021 AND 2020, RESPECTIVELY. NAHS REMEASURED ITS DEFERRED TAX ASSETS AND LIABILITIES BASED ON THE RATES AT WHICH THEY ARE EXPECTED TO REVERSE IN THE FUTURE, WHICH IS GENERALLY 21%. A FULL VALUATION ALLOWANCE HAS BEEN PROVIDED AT DECEMBER 31, 2021 AND 2020 TO OFFSET THE DEFERRED TAX ASSET SINCE HEALTHCARE CORPORATION HAS DETERMINED THAT IT IS MORE LIKELY THAN NOT THAT THE BENEFIT OF THE NET OPERATING LOSS CARRYFORWARDS WILL NOT BE REALIZED IN FUTURE YEARS. THE INCOME TAXES TOPIC OF THE ACCOUNTING STANDARDS CODIFICATION (ASC) (ASC 740) PRESCRIBES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS RECOGNIZED IN FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN, OR EXPECTED TO BE TAKEN, IN A TAX RETURN. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 AND 2020. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 600.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,534,256 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,534,256 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,898,509 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,803,697 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,094,812 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04150 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,432,765 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,803,697 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,629,068 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06480 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,550 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,550 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,397 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,397 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $92,069 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $92,069 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $125,016 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $125,016 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,557,781 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,803,697 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,754,084 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,347 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,347 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,333 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,307 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,307 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,987 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,987 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $142,126 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $128,894 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $29,199,663 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $29,385,916 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$186,253 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVENTIST BOLINGBROOK HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 REMINGTON BLVD | AddressLine1Txt |
| City | BOLINGBROOK | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60440 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ADVENTHEALTH.COM/HOSPITAL/ADVENTHE | WebsiteAddressTxt |
| State License | 0005496 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADVENTIST BOLINGBROOK HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 600.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ADVENTIST BOLINGBROOK HOSPITAL | PART V, SECTION B, LINE 5: ADVENTIST BOLINGBROOK HOSPITAL (ABH OR THE HOSPITAL) COLLABORATED WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS TO CONDUCT A JOINT CHNA IN 2019. ALL THE COLLABORATORS IN THE 2019 JOINT CHNA DEFINED THEIR COMMUNITY TO BE WILL COUNTY, ILLINOIS. WILL COUNTY, ILLINOIS HAS A POPULATION OF OVER 700,000 AND IS COMPRISED OF 23 CITIES, INCLUDING JOLIET, PLAINFIELD, BOLINGBROOK, AND ROMEOVILLE. THE 2019 JOINT CHNA WAS A COLLABORATIVE EFFORT OF THE MOBILIZING FOR ACTION IN PLANNING AND PARTNERSHIP (MAPP) COLLABORATIVE. THE HOSPITAL WAS AN EXECUTIVE COMMITTEE MEMBER OF THE MAPP COLLABORATIVE, ALONG WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS AND INCLUDING THE WILL COUNTY HEALTH DEPARTMENT. MAPP IS A COMMUNITY DRIVEN, STRATEGIC PLANNING PROCESS THAT ASSISTS COMMUNITIES IN DEVELOPING AND IMPLEMENTING EFFORTS AROUND THE PRIORITIZATION OF PUBLIC HEALTH ISSUES. AS A PART OF THE COMMUNITY HEALTH ASSESSMENT AND DATA COLLECTION EFFORTS, A SPECIFIC EFFORT WAS MADE TO INCLUDE INPUT FROM UNDERREPRESENTED POPULATION GROUPS AND PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. THE WILL COUNTY MAPP COLLABORATIVE CONDUCTED A SURVEY AMONG WILL COUNTY RESIDENTS TO ASSESS THE COMMUNITY'S PERCEPTIONS, THOUGHTS AND OPINIONS OF HEALTH AND THE QUALITY OF LIFE IN THEIR COMMUNITY. THE SURVEY WAS OPEN TO ALL WILL COUNTY RESIDENTS AND 1,688 SURVEYS WERE COLLECTED. THE MAPP COLLABORATIVE MADE A SPECIAL EFFORT TO GATHER INPUT FROM UNDERREPRESENTED POPULATIONS, INCLUDING THE FOLLOWING GROUPS: LATINO/HISPANIC, AFRICAN AMERICAN, YOUTH, AND RESIDENTS FROM CERTAIN IDENTIFIED COMMUNITY AREAS. IN ORDER TO REACH THESE POPULATIONS, PAPER COPIES OF THE SURVEY WERE DISTRIBUTED TO VARIOUS GROUPS THROUGHOUT WILL COUNTY, INCLUDING THE SPANISH COMMUNITY CENTER, NORTHERN ILLINOIS FOOD BANK MOBILE PANTRY SITES, AND YMCA SITES. SURVEYS WERE ALSO COLLECTED FROM CLIENTS OF THE WILL COUNTY COMMUNITY HEALTH CENTER IN WAITING AREAS. QUESTIONS ADDRESSING HEALTH EQUITY WERE INCLUDED IN THE SURVEY TO HELP MEASURE THE EFFECTS OF DISCRIMINATION ON HEALTH. RESPONDENTS WERE ASKED TO IDENTIFY PERCEPTIONS OF DISCRIMINATION DUE TO RACE, ETHNICITY, AND COLOR IN WILL COUNTY. |
| ADVENTIST BOLINGBROOK HOSPITAL | PART V, SECTION B, LINE 6A: ADVENTIST BOLINGBROOK HOSPITAL (ABH OR THE HOSPITAL) COLLABORATED WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS TO CONDUCT A JOINT CHNA IN 2019. ALL THE COLLABORATORS IN THE 2019 JOINT CHNA DEFINED THEIR COMMUNITY TO BE WILL COUNTY, ILLINOIS. WILL COUNTY, ILLINOIS HAS A POPULATION OF OVER 700,000 AND IS COMPRISED OF 23 CITIES, INCLUDING JOLIET, PLAINFIELD, BOLINGBROOK, AND ROMEOVILLE. THE 2019 JOINT CHNA WAS A COLLABORATIVE EFFORT OF THE MOBILIZING FOR ACTION IN PLANNING AND PARTNERSHIP (MAPP) COLLABORATIVE. THE HOSPITAL WAS AN EXECUTIVE COMMITTEE MEMBER OF THE MAPP COLLABORATIVE, ALONG WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS AND INCLUDING THE WILL COUNTY HEALTH DEPARTMENT. THE OTHER HOSPITAL ORGANIZATIONS THAT PARTICIPATED IN THE 2019 JOINT CHNA AS EXECUTIVE COMMITTEE MEMBERS OF THE MAPP COLLABORATIVE INCLUDED AMITA HEALTH SAINT JOSEPH MEDICAL CENTER, SILVER CROSS HOSPITAL, AND EDWARD ELMHURST HEALTH. |
| ADVENTIST BOLINGBROOK HOSPITAL | PART V, SECTION B, LINE 6B: ADVENTIST BOLINGBROOK HOSPITAL (ABH OR THE HOSPITAL) COLLABORATED WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS TO CONDUCT A JOINT CHNA IN 2019. ALL THE COLLABORATORS IN THE 2019 JOINT CHNA DEFINED THEIR COMMUNITY TO BE WILL COUNTY, ILLINOIS. WILL COUNTY, ILLINOIS HAS A POPULATION OF OVER 700,000 AND IS COMPRISED OF 23 CITIES, INCLUDING JOLIET, PLAINFIELD, BOLINGBROOK, AND ROMEOVILLE. THE 2019 JOINT CHNA WAS A COLLABORATIVE EFFORT OF THE MOBILIZING FOR ACTION IN PLANNING AND PARTNERSHIP (MAPP) COLLABORATIVE. THE HOSPITAL WAS AN EXECUTIVE COMMITTEE MEMBER OF THE MAPP COLLABORATIVE, ALONG WITH OTHER HOSPITAL AND NON-HOSPITAL ORGANIZATIONS AND INCLUDING THE WILL COUNTY HEALTH DEPARTMENT. THE OTHER NON-HOSPITAL ORGANIZATIONS THAT PARTICIPATED IN THE 2019 JOINT CHNA AS EXECUTIVE COMMITTEE MEMBERS OF THE MAPP COLLABORATIVE INCLUDED THE WILL COUNTY HEALTH DEPARTMENT, WILL COUNTY EXECUTIVE'S OFFICE, WILL COUNTY COMMUNITY HEALTH CENTER, THE WILL COUNTY BOARD, AUNT MARTHA'S YOUTH SERVICES, GOVERNORS STATE UNIVERSITY, GREATER JOLIET YMCA, SENIOR SERVICES OF WILL COUNTY, STEPPING STONES, INC., UNITED WAY OF WILL COUNTY, CATHOLIC CHARITIES, EASTERSEALS JOLIET REGION, INC., VALLEY VIEW SCHOOL DISTRICT, AND THE WILL-GRUNDY MEDICAL CLINIC. |
| ADVENTIST BOLINGBROOK HOSPITAL | PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. COPIES OF THE CHNA REPORT WERE MAILED AND/OR E-MAILED TO COMMUNITY PARTNERS WHO PARTICIPATED IN THE CHNA PROCESS. PARTNERS WERE ALSO PROVIDED LINKS TO THE WEBSITE FOR DISSEMINATION TO THEIR MAILING LISTS AND RESPECTIVE CONSTITUENTS. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE AT ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESMENTS AND IS ALSO BROADLY DISTRIBUTED WITHIN OUR COMMUNITY TO STAKEHOLDERS INCLUDING COMMUNITY LEADERS, GOVERNMENT OFFICIALS, AND SERVICE ORGANIZATIONS. |
| ADVENTIST BOLINGBROOK HOSPITAL | PART V, SECTION B, LINE 11: THE INFORMATION PROVIDED BELOW EXPLAINS HOW ADVENTIST BOLINGBROOK HOSPITAL (THE HOSPITAL) ADDRESSED IN 2021 THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, AND ANY SUCH NEEDS THAT WERE NOT ADDRESSED AND THE REASONS WHY SUCH NEEDS WERE NOT ADDRESSED. THE HOSPITAL FACILITY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT BY 12/31/19 AND ADOPTED AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2020 PRIOR TO MAY 15, 2020. THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH BOLINGBROOK'S (THE HOSPITAL) 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH BOLINGBROOK WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE SECOND-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS. ADVENTHEALTH BOLINGBROOK CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. BEHAVIORAL HEALTH AND SUSTANCE USE2. ACCESS TO HEALTH CARE3. ACCESS TO FOOD AND NUTRITION4. STABILIZING THE BUILT ENVIRONMENT PRIORITY 1: BEHAVIORAL HEALTH AND SUSTANCE USE2019 DESCRIPTION OF THE ISSUE:BEHAVIORAL HEALTH IS A TERM THAT INCLUDES BOTH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. THE BURDEN OF MENTAL ILLNESS IN THE UNITED STATES IS AMONG THE HIGHEST OF ALL DISEASES, AND MENTAL DISORDERS ARE AMONG THE MOST COMMON CAUSES OF DISABILITY FOR ADULTS, CHILDREN, AND ADOLESCENTS. WHEN MENTAL HEALTH DISORDERS ARE UNTREATED, THOSE AFFECTED ARE AT HIGH RISK FOR MANY UNHEALTHY AND UNSAFE BEHAVIORS, INCLUDING ALCOHOL OR DRUG ABUSE, VIOLENT OR SELF-DESTRUCTIVE BEHAVIOR AND SUICIDE. MENTAL HEALTH DISORDERS ARE THE 11TH LEADING CAUSE OF DEATH IN THE UNITED STATES FOR ALL AGE GROUPS AND THE SECOND LEADING CAUSE OF DEATH AMONG PEOPLE AGE 25 TO 34. IN THE ADVENTHEALTH BOLINGBROOK COUNTY AREA, MENTAL HEALTH DISORDERS ATTRIBUTED TO 7.8% OF WILL COUNTY HOSPITALIZATIONS IN 2014 AND IS THE THIRD LEADING CAUSE OF HOSPITALIZATIONS OVERALL. BEHAVIORAL HEALTH CONTINUES TO BE A PRIMARY CONCERN IN WILL COUNTY. 2021 UPDATE: THE ADVENTHEALTH BOLINGBROOK COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE BEHAVIORAL HEALTH AND SUSTANCE USE PRIORITY. 1. IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.GOAL 1: IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE ABUSE.OBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS, ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THE OBJECTIVE, TO INCREASE PERSONS TRAINED IN THE COMMUNITY ON MENTAL HEALTH FIRST AID (MHFA) TO INCREASE IDENTIFICATION OF THOSE IN A CRISIS AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH ISSUES IS FUNDED AND CONDUCTED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES A TRAINING FOR COMMUNITY RESIDENTS AND FIRST RESPONDERS TO RECOGNIZE, RESPOND AND SEEK ASSISTANCE FOR SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. THE HOSPITALS PROGRESSED ON THEIR SET METRIC OF 200 INDIVIDUALS TO BE TRAINED WITH 11 INDIVIDUALS SERVED. IN 2021, THERE WAS ONLY ONE MHFA FACILITATOR THAT WAS SHARED AMONGST 14 HOSPITALS AND ENDED IN AUGUST. NO FACILITATOR WAS AVAILABLE FOR THE REST OF 2021. PRIORITY 2: ACCESS TO HEALTH CARE2019 DESCRIPTION OF THE ISSUE:HEALTHY PEOPLE 2020 STATES THAT ACCESS TO COMPREHENSIVE HEALTHCARE SERVICES IS IMPORTANT FOR ACHIEVING HEALTH EQUITY AND IMPROVING QUALITY OF LIFE FOR EVERYONE. DISPARITIES IN ACCESS TO CARE AND COMMUNITY RESOURCES WERE IDENTIFIED AS UNDERLYING ROOT CAUSES OF MANY OF THE HEALTH INEQUITIES EXPERIENCED BY RESIDENTS IN WILL COUNTY. IN 2016, 10.35% OF THE WILL COUNTY WORKING AGE POPULATION (18-64 YEARS OLD) WAS UNINSURED. ACCESS HAS MULTIPLE COMPONENTS TO ADDRESS INCLUDING AVAILABILITY, AFFORDABILITY, PROXIMITY, AND TIMELINESS. ADDRESSING THE COORDINATION AND LINKAGE TO A PRIMARY MEDICAL HOME, BENEFITS ENROLLMENT AND ACCESS TO SERVICES AND RESOURCES ARE OPPORTUNITIES TO ADDRESS. 2021 UPDATE: THE ADVENTHEALTH BOLINGBROOK COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE ACCESS TO HEALTH CARE PRIORITY. 1. INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.GOAL 1: INCREASING ACCESS TO CARE AND COMMUNITY RESOURCES.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE THE NUMBER OF PERSONS WITH A PRIMARY MEDICAL HOME. THE PARTNERSHIP WITH VNA HEALTH CARE IS DEPLOYED THROUGH ADVENTHEALTH BOLINGBROOK AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE PARTNERSHIP WITH VNA HEALTH CARE PROVIDES PRIMARY HEALTH CARE FOR THOSE UNINSURED AND UNDERINSURED. A VNA HOSPITAL LIAISON WILL ROUND IN THE EMERGENCY DEPARTMENT AS WELL AS INPATIENT UNITS TO COORDINATE PRIMARY CARE VISITS FOR PATIENTS. THE HOSPITAL FELL SHORT OF ITS SET METRIC OF 75% OF PATIENTS SCHEDULED FOR POST-DISCHARGE AT VNA WHO WILL ATTEND THEIR APPOINTMENTS WITH 0 INDIVIDUALS SERVED. THIS OBJECTIVE FELL SHORT FOR SEVERAL REASONS INCLUDING THE LACK OF FUNDING FOR THE VNA HOSPITAL LIAISON IN THE EMERGENCY DEPARTMENT AND INPATIENT UNITS THAT ENDED IN 2019, STAFF TURNOVER AND THE COVID-19 PANDEMIC. OBJECTIVE 2: THE SECOND OBJECTIVE IS A SHARED INITIATIVE BETWEEN ADVENTHEALTH BOLINGBROOK, ADVENTHEALTH GLENOAKS AND ADVENTHEALTH HINSDALE AND ADVENTHEALTH LA GRANGE. THE HOSPITALS PARTNERED ON THIS INITIATIVE BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE PATIENT AND COMMUNITY MEMBERS' CONNECTION TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE COMMUNITY RESOURCE DIRECTORY, IS MANAGED THROUGH ALL HOSPITALS, HOWEVER REPORTED OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES AN ONLINE DIRECTORY OF FREE OR REDUCED COST SERVICES THAT ADDRESS SOCIAL NEEDS SUCH AS MEDICAL CARE, FOOD, JOB TRAINING, UTILITY ASSISTANCE, HOUSING, TRANSPORTATION, LEGAL SERVICES AND MORE. THE HOSPITALS DID NOT MEET THEIR SET METRIC OF 60% OF PATIENTS IN NEED WILL BE DIRECTLY REFERRED TO A LOCAL AGENCY FOR ASSISTANCE WITH 0 INDIVIDUALS SERVED. SEVERAL REASONS CONTRIBUTED TO NOT MEETING THIS METRIC. ONE OF THE PRIMARY REASONS WAS A LACK OF AWARENESS OF THE COMMUNITY RESOURCE DIRECTORY AVAILABILITY. IN ADDITION THE COVID-19 PANDEMIC DELAYED THE PROGRAM. SEE CONTINUATION |
| ADVENTIST BOLINGBROOK HOSPITAL | PART V, SECTION B, LINE 13H: THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) IMPLEMENTED A COVID-19 EMERGENCY FINANCIAL HARDSHIP POLICY IN WHICH UNINSURED PATIENTS WHO ARE TREATED FOR COVID-19 RELATED EVALUATION AND/OR TREATMENT WILL NOT BE BILLED. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS INCLUDING A REQUEST TO DEFER ANY PAYMENT PLAN PAYMENT FOR AN INITIAL PERIOD OF UP TO 120 DAYS. |
| ADVENTIST BOLINGBROOK HOSPITAL | PART V, SECTION B, LINE 16J: THE FILING ORGANIZATION USES MULTIPLE METHODS OF COMMUNICATING ITS MISSION OF PROVIDING CARE TO ALL WHO NEED IT REGARDLESS OF ABILITY TO PAY. SIGNS POSTED AT REGISTRATION CLEARLY POINT OUT THAT CHARITY CARE OR FINANCIAL ASSISTANCE IS AVAILABLE. REGISTRATION IS EDUCATED ON PROVIDING FINANCIAL ASSISTANCE POLICY INFORMATION AND FORMS TO PATIENTS. THE MAIN WEBSITE FOR ALL SYSTEM HOSPITALS FEATURES INFORMATION ON HOW TO APPLY FOR FINANCIAL ASSISTANCE ON-LINE. IN THE HOSPITAL SETTING, WE EMPLOY FINANCIAL COUNSELORS WHO ARE AVAILABLE TO WORK WITH PATIENTS AND WE ALSO HAVE MEDICAID APPLICATION SPECIALISTS TO ASSIST PATIENTS THAT MAY QUALIFY. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE. |
| PART V, SECTION B, LINE 11 - CONTINUATION | PRIORITY 3: ACCESS TO FOOD AND NUTRITION2019 DESCRIPTION OF THE ISSUE:ADULTS WHO ARE FOOD INSECURE CAN BE AT AN INCREASED RISK FOR NEGATIVE HEALTH OUTCOMES, INCLUDING OBESITY AND OTHER CHRONIC DISEASES. IN ADDITION, IT CAN IMPACT CHILDREN, PUTTING THEM AT AN INCREASED RISK OF DEVELOPMENTAL PROBLEMS. FOOD INSECURITY IN WILL COUNTY AFFECTS NEARLY 10% OF ALL RESIDENTS, OF WHICH EVEN MORE HAVE NO ACCESS TO HEALTHY FOOD RETAILERS. OF THE MORE THAN 34,000 CHILDREN EXPERIENCING FOOD INSECURITY, 46% ARE INELIGIBLE FOR ASSISTANCE PROGRAMS. THERE ARE GEOGRAPHIC FOOD DESERTS IN PARTS OF WILL COUNTY THAT ARE PRIMARILY IN LOW-INCOME AREAS. OBESITY CONTINUES TO BE AN ISSUE FOR ADULTS AS WELL AS HIGH RATES OF HOSPITALIZATION FOR DIABETES AMONG THE HISPANIC AND LATINO ETHNICITIES. 2021 UPDATE: THE ADVENTHEALTH BOLINGBROOK COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE ACCESS TO FOOD AND NUTRITION PRIORITY. 2. TO DEVELOP AFFORDABLE, HEALTHY FOOD OPTIONS FOR ALL RESIDENTS OF WILL COUNTYGOAL 1: TO DEVELOP AFFORDABLE, HEALTHY FOOD OPTIONS FOR ALL RESIDENTS OF WILL COUNTYOBJECTIVE 1: THE FIRST OBJECTIVE IS A SHARED INITIATIVE WITH ADVENTHEALTH BOLINGBROOK AND ADVENTHEALTH GLENOAKS. BECAUSE OF A SHARED CHNA PRIORITY. THIS OBJECTIVE, TO INCREASE AVAILABILITY OF HEALTHY FOODS WITHIN THE LOW-INCOME COMMUNITY, IS FUNDED AND DEPLOYED THROUGH ADVENTHEALTH BOLINGBROOK AND ALL FUNDING AND OUTCOMES REPORTED ARE SPECIFIC TO THE REPORTING HOSPITAL. THIS INITIATIVE PROVIDES MOBILE FOOD PANTRIES IN AREAS OF HIGH NEED AS WELL AS MICRO-PANTRIES AT EACH HOSPITAL. THE HOSPITAL FELL SHORT OF ITS SET METRIC OF A MONTHLY AVERAGE OF 200 PERSONS PROVIDED WITH FREE HEALTHY FOOD OPTIONS WITH A MONTHLY AVERAGE OF 28 INDIVIDUALS SERVED. THERE HAS BEEN GREAT COLLABORATION WITH FAITH ORGANIZATIONS AND MUNICIPAL LEADERS TO BE ABLE TO IMPLEMENT THESE INITIATIVES AS WELL AS ENGAGEMENT FROM ASSOCIATES TO VOLUNTEER. THE MICRO-PANTRY LOCATED ON-SITE AT THE HOSPITAL PROVIDES FOOD ACCESS THROUGHOUT THE YEAR. THE MICRO PANTRY ALSO PROVIDES TOILETRIES AND DIAPERS FOR THE COMMUNITY. PRIORITY 4: STABILIZING THE BUILT ENVIRONMENT 2019 DESCRIPTION OF THE ISSUE:IMPROVING HEALTH OUTCOMES INCLUDES ADDRESSING SOCIAL DETERMINANTS OF HEALTH SUCH AS THE BUILT ENVIRONMENT. WHERE PEOPLE LIVE CAN IMPACT THEIR HEALTH AND WELL-BEING. THOSE LIVING IN POVERTY ARE AT GREATER RISK OF FOOD INSECURITY, HOMELESSNESS, INFECTIOUS DISEASES, ENVIRONMENTAL HAZARDS, AND POOR ACADEMIC PERFORMANCE. IN WILL COUNTY, HOUSING SECURITY IS LISTED AS AN ISSUE IN ALL MAJOR STRATEGIC CATEGORIES. 2021 UPDATE:THE ADVENTHEALTH BOLINGBROOK COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENT UNDER THE STABILIZING THE BUILT ENVIRONMENT PRIORITY. 1. TO CREATE THE LINKAGE BETWEEN BETTER BUILT ENVIRONMENT AND HEALTH CARE.GOAL 1: TO CREATE THE LINKAGE BETWEEN BETTER BUILT ENVIRONMENT AND HEALTH CARE.OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE COMMUNITY MEMBERS' CONNECTION TO SERVICES TO ADDRESS SOCIAL DETERMINANTS OF HEALTH THROUGH THE PROVISION OF THE SOCIAL WORKER IN A LIBRARY PROGRAM. THE SOCIAL WORKER IN A LIBRARY PROGRAM (SWIL), IS MANAGED THROUGH ADVENTHEALTH BOLINGBROOK AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE SOCIAL WORKER IN A LIBRARY PROGRAM PROVIDES A LICENSED CLINICAL SOCIAL WORKER AT A LIBRARY TO CONNECT INDIVIDUALS WHO ARE EXPERIENCING HOMELESSNESS, CHRONIC UNEMPLOYMENT, MENTAL ILLNESS, AND OTHER COMPLEX NEEDS WITH APPROPRIATE REFERRALS AND SUPPORTS UTILIZING THE COMMUNITY RESOURCE DIRECTORY. SWIL PROVIDES A SAFE PLACE WHERE PEOPLE ARE WELCOME. SWIL IS AN ADVENTHEALTH PROGRAM WHICH INCREASES COMMUNITY MEMBERS' CONNECTIONS TO SERVICES TO REDUCE SOCIAL DETERMINANTS OF HEALTH. THE HOSPITAL DID NOT MEET ITS SET METRIC OF 90% OF INDIVIDUALS SERVED WITH AN IDENTIFIED NEED WILL BE REFERRED TO APPROPRIATE SOURCES USING THE COMMUNITY RESOURCE DIRECTORY, WITH 0 INDIVIDUALS SERVED. DUE TO COVID-19, THE PROGRAM WAS DELAYED. THE FOLLOWING HEALTH ISSUES WERE IDENTIFIED IN THE CHNA BUT NOT ADDRESSED SPECIFICALLY AS THEY ARE CONSIDERED TO HAVE BEEN INCORPORATED INTO ONE OF THE PRIORITIZED ISSUES ADDRESSED ABOVE:TRANSPORTATION ACCESS;INTERPRETER/LANGUAGE TRANSLATION ACCESS; ANDHOUSING STABILIZATION. |
| SCHEDULE H, PART V, SECTION B, LINE 7A: | THE CHNA REPORT CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS |
| SCHEDULE H, PART V, SECTION B, LINE 10A: | THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS |
| SCHEDULE H, PART V, SECTION B, LINE 16A,B,C: | THE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCETHE PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - AMITA CANCER INSTITUTE - RETAIL PHARMACY | ||||
| 1 SALT CREEK LANE | HINSDALE | IL | 60521 | CANCER CENTER - RETAIL PHARMACY |
| 2 - ADVENTIST BOLINGBROOK HOSPITAL | ||||
| 420 REMINGTON BLVD 135 | BOLINGBROOK | IL | 60440 | OUTPATIENT REHABILITATION FACILITY |
| 3 - WOMEN'S IMAGING CENTER | ||||
| 396 REMINGTON BLVD 235 | BOLINGBROOK | IL | 60440 | IMAGING CENTER |
| 4 - ADVENTIST PLAINFIELD PHYSICAL THERAPY | ||||
| 15728 S ROUTE 59 | PLAINFIELD | IL | 60544 | OUTPATIENT REHABILITATION FACILITY |
| 5 - MATERNAL FETAL MEDICINE DEPT | ||||
| 396 REMINGTON BLVD 231 | BOLINGBROOK | IL | 60440 | MATERNAL FETAL MEDICINE |
| 6 - PLAINFIELD IMAGING & OUTPATIENT CENTER | ||||
| 15728 S ROUTE 59 | PLAINFIELD | IL | 60544 | IMAGING CENTER |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | EVERY UNINSURED PERSON, REGARDLESS OF INCOME, RECEIVES AN AUTOMATIC 15% DISCOUNT OFF OF CHARGES. PERSONS WHO EARN LESS THAN 600% OF THE FEDERAL POVERTY GUIDELINES ARE GIVEN MORE SIGNIFICANT DISCOUNTS, DEPENDING ON THEIR INDIVIDUAL SITUATIONS.FEDERAL POVERTY LEVEL - 0-200% UNINSURED PATIENT DISCOUNT - 95%FEDERAL POVERTY LEVEL - 201-300% UNINSURED PATIENT DISCOUNT - 75%FEDERAL POVERTY LEVEL - 301-600% UNINSURED PATIENT DISCOUNT - 74%FEDERAL POVERTY LEVEL - > 600% UNINSURED PATIENT DISCOUNT - 74% |
| PART I, LINE 6A: | THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS "ADVENTHEALTH".ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE.THE FILING ORGANIZATION IS INCLUDED IN THE SUBMISSION OF THE ANNUAL NONPROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS REPORT IS PREPARED ON A CONSOLIDATED BASIS AND INCLUDES DATA FOR ADVENTIST MIDWEST HEALTH, ADVENTIST GLENOAKS HOSPITAL, AND ADVENTIST BOLINGBROOK HOSPITAL. THESE HOSPITAL ORGANIZATIONS ARE ALL RELATED ORGANIZATIONS. |
| PART I, LINE 7: | THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS. - CHARITY AT COST - A COST TO CHARGE METHODOLOGY BASED ON THE MOST RECENTLY FILED MEDICARE COST REPORT WAS USED TO CALCULATE COSTS. - UNREIMBURSED MEDICAID - COSTS ARE CALCULATED USING THE MOST RECENTLY FILED MEDICAID COST REPORT. - OTHER BENEFITS - COSTS ARE DETERMINED BY ACTIVITY REPORTED IN ACCORDANCE WITH GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION. COSTS COULD INCLUDE THE VALUE OF HOURLY WAGES, COSTS OF MATERIALS, VALUE OF SPACE LOANED TO COMMUNITY GROUPS FOR MEETINGS, AND INDIRECT COSTS WHERE APPLICABLE. |
| PART III, LINE 2: | AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE FILING ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY AMITA HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE FILING ORGANIZATION'S POLICIES. |
| PART III, LINE 3: | THE FILING ORGANIZATION PROACTIVELY WORKS TO PRESUMPTIVELY ASSESS AND GRANT CHARITY TO ALL UNINSURED PATIENTS. THE HOSPITAL SCREENS ALL UNINSURED PATIENTS AGAINST CREDIT SCORE DATA IN ORDER TO PRESUMPTIVELY APPLY ITS FINANCIAL ASSISTANCE POLICY. BASED ON THIS PROCESS, APPROXIMATELY 96% OF THE UNINSURED PATIENT POPULATION IS DEFINED AS ELIGIBLE FOR A PARTIAL CHARITY ADJUSTMENT ON THEIR ACCOUNTS. THE AVERAGE DISCOUNT GIVEN TO THE UNINSURED PATIENT POPULATION IS 81%. IN PRIOR YEARS, PROACTIVE EFFORTS WERE LIMITED TO ONLY THOSE ACCOUNTS WITH BALANCES > $5,000. UNDER THAT SCENARIO, IT WAS ESTIMATED THAT 1/3 OF OUR BAD DEBT PLACEMENTS MAY HAVE BEEN ELIGIBLE FOR CHARITY CARE DISCOUNTS. WITH A MORE COMPREHENSIVE PRESUMPTIVE CHARITY PROGRAM, MANY MORE ACCOUNTS ARE GRANTED CHARITY EARLIER IN THE PROCESS AND PRIOR TO BAD DEBT PLACEMENT. THEREFORE, IT IS ESTIMATED THAT APPROXIMATELY 10% OF OUR CURRENT BAD DEBT PLACEMENTS WOULD BE ELIGIBLE FOR ADDITIONAL CHARITY IF A FULL PRESUMPTIVE CHARITY PROCESS WAS CONDUCTED ACROSS 100% OF OUR SELF-PAY AFTER INSURANCE ACCOUNTS.DISCOUNTS AND PAYMENTS ARE NOT INCLUDED IN BAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS UNLESS THE PAYMENT IS A RECOVERY OF AMOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT. RECOVERIES ARE CLASSIFIED AS A DECREASE TO BAD DEBT EXPENSE.RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY. |
| PART III, LINE 4: | FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8-9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS. |
| PART III, LINE 8: | COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT. |
| PART III, LINE 9B: | IT IS THE POLICY OF THE FILING ORGANIZATION TO OFFER PATIENTS A PAYMENT PLAN AND/OR CHARITY ASSISTANCE WHEN IT BECOMES KNOWN OR EVEN SUSPECTED THAT A PATIENT NEEDS FINANCIAL ASSISTANCE. SIGNS AND BROCHURES ARE POSTED IN FACILITY REGISTRATION AREAS. FINANCIAL COUNSELORS ARE NOTIFIED AND EVERY ATTEMPT IS MADE TO CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP THEM COMPLETE A FINANCIAL ASSISTANCE APPLICATION WITH COMPASSION AND DIGNITY. FINANCIAL COUNSELORS WORK WITH PATIENTS TO HELP DETERMINE IF THERE ARE ANY THIRD-PARTY PAYORS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS. THE HOSPITAL WORKS WITH THE PATIENT TO DETERMINE IF THEY ARE ELIGIBLE FOR FEDERAL PROGRAMS INCLUDING MEDICAID, STATE FUNDED PROGRAMS INCLUDING CRIME VICTIMS, ALTERNATIVE INSURANCE INCLUDING COBRA, WORKER'S COMPENSATION AND OR OTHER SPECIALIZED GRANT PROGRAMS SUCH AS OUR MAMMOGRAPHY GRANT PROGRAM FOR LOW INCOME WOMEN. IN THE EVENT NO THIRD-PARTY PROGRAMS ARE IDENTIFIED, THE HOSPITAL THEN WORKS WITH THE PATIENT TO HELP THEM APPLY FOR FINANCIAL ASSISTANCE DISCOUNTS AND PAYMENT PLANS. IN ADDITION, ALL BILLS AND STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE. |
| SCHEDULE H, PART III, SECTION B | SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B, LINE 8 RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO ALL MEDICARE PATIENTS ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ (186,253)- DIFFERENCE IN COSTING METHODOLOGY: 2,410,996- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: $(3,937,393) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITYBENEFIT REPORTING $ (1,712,650)AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION. |
| PART VI, LINE 2: | THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2019 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2019, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2019 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1. A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2. POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3. SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4. COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY. |
| PART VI, LINE 3: | THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE WEBSITE INDICATES THAT A COPY OF THE FAP, FAA FORM, AND PLS IS AVAILABLE AND HOW TO OBTAIN SUCH COPIES IN THE PRIMARY LANGUAGES OF ANY POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | ADVENTIST BOLINGBROOK HOSPITAL (AHH) IS A 138-BED STATE-OF-THE-ART ACUTE CARE HOSPITAL SERVING THE RESIDENTS OF THE VILLAGE OF BOLINGBROOK, ILLINOIS AND SURROUNDING COMMUNITIES. BOLINGBROOK IS LOCATED IN WILL COUNTY, ILLINOIS. PRIOR TO THE BUILDING OF THE HOSPITAL, ADVENTIST MIDWEST HEALTH, AN AFFILIATE OF THE HOSPITAL, OPERATED A FREE-STANDING EMERGENCY CENTER IN THE VILLAGE OF BOLINGBROOK. THE HOSPITAL IS MEETING A DEMAND FOR ACUTE CARE INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES IN THE COMMUNITY IT SERVES. THE HOSPITAL OFFERS THE LATEST TECHNOLOGICAL ADVANCES AND WAS DESIGNED TO OFFER ALL FAMILY-FRIENDLY PRIVATE PATIENT ROOMS. SERVICES OFFERED AT THE HOSPITAL INCLUDE CARDIAC CARE, IMAGING SERVICES, A WOMEN'S CARE CENTER, INCLUDING A MATERNAL FETAL CENTER, SURGICAL SERVICES AND INTERVENTIONAL RADIOLOGY. THE HOSPITAL OPENED A NEW WOUND CARE CENTER IN 2013 AND HAS ALSO ESTABLISHED AN AGREEMENT WITH VNA HEALTH CARE TO OFFER A FEDERALLY QUALIFIED HEALTH CENTER ON THE HOSPITAL CAMPUS TO PROVIDE CARE FOR THE UNINSURED AND UNDERINSURED.THE ADVENTIST BOLINGBROOK HOSPITAL COMMUNITY CONSISTS PRIMARILY OF BOLINGBROOK AND THE SURROUNDING AREA. WE DEFINE THE PRIMARY SERVICE AREA (PSA) AS THE COLLECTION OF ZIP CODES WHERE APPROXIMATELY 75% OF HOSPITAL PATIENTS RESIDE, AND WE FOCUS OUR COMMUNITY HEALTH IMPROVEMENT ON THIS SERVICE AREA. THE LARGEST PRIMARY SERVICE AREA RESIDES IN WILL COUNTY. A SMALL PART OF THE NORTHERN/NORTHEASTERN SERVICE AREA IS IN DUPAGE COUNTY. ZIP CODES FOR THE SERVICE AREA INCLUDED: 60517, 60440, 60439, 60490, 60446, 60544, 60403, 60435, AND 60441. ACCORDING TO US CENSUS DATA (2018) THE POPULATION OF THIS SERVICE AREA IS 300,313. THE AVERAGE AGE IS 37.9 YEARS WITH AN AVERAGE FAMILY INCOME OF $78,826. THE AGE SPREAD OF THE PRIMARY SERVICE AREA IS SIMILAR TO WILL COUNTY, DUPAGE COUNTY AND ILLINOIS. EIGHT PERCENT OF THOSE THAT RESIDE IN THIS SERVICE AREA ARE LIVING IN POVERTY. THE PRIMARY SERVICE AREA OF ADVENTIST BOLINGBROOK HOSPITAL HAS A SLIGHTLY HIGHER HISPANIC/LATINO POPULATION AND NON-HISPANIC BLACK POPULATION THAN WILL COUNTY AND DUPAGE COUNTY. DURING 2021, THE HOSPITAL'S PATIENT PERCENTAGE POPULATION WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. APPROXIMATELY 40% OF THE HOSPITAL'S PATIENTS WERE MEDICARE PATIENTS, ABOUT 18% WERE MEDICAID PATIENTS, ABOUT 2.9% WERE SELF-PAY PATIENTS. IN 2021, ABOUT 76.1% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. |
| PART VI, LINE 5: | THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO ADVENTIST BOLINGBROOK HOSPITAL'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF "EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. DURING THE CURRENT YEAR, THE HOSPITAL EXPENDED $4,438,768 IN NEW CAPITAL IMPROVEMENTS. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY. |
| PART VI, LINE 6: | ADVENTIST BOLINGBROOK HOSPITAL IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 48 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 10 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. THE FILING ORGANIZATION IS ALSO A COVERED AFFILIATE OF A JOINT OPERATING COMPANY THAT DOES BUSINESS UNDER THE NAME OF AMITA HEALTH. AMITA HEALTH HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION UNDER IRC SECTION 501(C)(3). AMITA HEALTH PROVIDES VARIOUS MANAGEMENT AND EXECUTIVE SUPPORT SERVICES TO THE FILING ORGANIZATION. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AMITA HEALTH AND BY ADVENTHEALTH PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING THE HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION AS A COVERED AFFILIATE OF AMITA HEALTH AND AS PART OF A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITALS AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY THE FILING ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH OR OF AMITA HEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| WILL COUNTY CHAMBER OF COMMERCE | ||||||||
| 116 N CHICAGO ST 101 | JOLIET | IL | 60432 | 363772737 | 501(C)(6) | $15,000 | $0 | GENERAL SUPPORT |
| PRESENCE SENIOR SERVICES CHICAGOLAND DBA ASCENSION LIVING | ||||||||
| 18927 HICKORY CREEK DRIVE 300 | MOKENA | IL | 60448 | 237061646 | 501(C)(3) | $32,029 | $0 | GENERAL SUPPORT |
| BOLINGBROOK PARK DISTRICT | ||||||||
| 201 RECREATION DRIVE | BOLINGBROOK | IL | 60440 | 362731525 | GOV'T | $9,000 | $0 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS ARE GENERALLY MADE ONLY TO RELATED ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), OR TO OTHER LOCAL CHARITABLE COMMUNITY ORGANIZATIONS, OR TO OTHER 501(C)(3) ORGANIZATIONS THAT ARE A PART OF THE GROUP EXEMPTION RULING ISSUED TO THE GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS. ACCORDINGLY, THE FILING ORGANIZATION HAS NOT ESTABLISHED SPECIFIC PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES AS THE FILING ORGANIZATION DOES NOT HAVE A GRANT MAKING PROGRAM THAT WOULD NECESSITATE SUCH PROCEDURES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HAFFNER PHD RANDALL | ||||||||||||||
| DIR/CHAIRMAN (END 2/21) | $0 | $1,446,809 | $0 | $989,082 | $0 | $1,184,218 | $0 | $165,548 | $0 | $43,625 | $0 | $3,829,282 | $0 | $243,228 |
| SNYDER BRENT | ||||||||||||||
| DIRECTOR | $0 | $823,942 | $0 | $460,754 | $0 | $502,194 | $0 | $15,548 | $0 | $25,837 | $0 | $1,828,275 | $0 | $277,454 |
| BACON KENNETH | ||||||||||||||
| DIR/CHAIRMAN (BEG 3/21) | $0 | $840,732 | $0 | $8,687 | $0 | $228,614 | $0 | $169,010 | $0 | $32,952 | $0 | $1,279,995 | $0 | $0 |
| THORDARSON THOR | ||||||||||||||
| DIR/PRES/SEC/EVP & COO | $0 | $694,451 | $0 | $350,000 | $0 | $113,256 | $0 | $15,950 | $0 | $20,214 | $0 | $1,193,871 | $0 | $0 |
| MURRILL MICHAEL | ||||||||||||||
| FORMER COO | $0 | $587,700 | $0 | $93,590 | $0 | $19,324 | $0 | $117,171 | $0 | $43,792 | $0 | $861,577 | $0 | $0 |
| BUCHANAN HERBERT | ||||||||||||||
| DIRECTOR | $47,886 | $430,978 | $17,106 | $153,952 | $7,416 | $66,740 | $580 | $5,220 | $6,786 | $61,078 | $79,774 | $717,968 | $0 | $0 |
| CARROLL MD RICHARD | ||||||||||||||
| VP/CMO BOLINGBROOK/GLENOAK | $0 | $395,099 | $0 | $82,330 | $0 | $212,957 | $0 | $18,850 | $0 | $18,712 | $0 | $727,948 | $0 | $0 |
| CHRISTIAN BRUCE | ||||||||||||||
| PRES/CEO BOLINGBROOK/GLENO | $0 | $397,427 | $0 | $142,370 | $0 | $59,436 | $0 | $18,850 | $0 | $18,990 | $0 | $637,073 | $0 | $0 |
| ROEHR RICHARD | ||||||||||||||
| FORMER COO | $0 | $363,889 | $0 | $122,038 | $0 | $32,737 | $0 | $18,850 | $0 | $30,552 | $0 | $568,066 | $0 | $0 |
| MURPHY MARY | ||||||||||||||
| FORMER REGIONAL CNO | $0 | $351,316 | $0 | $100,444 | $0 | $45,376 | $0 | $18,850 | $0 | $11,030 | $0 | $527,016 | $0 | $0 |
| RADIVOJEVIC VLADIMIR | ||||||||||||||
| VP/COO BOLINGBROOK/GLENOAK | $0 | $256,062 | $0 | $54,704 | $0 | $12,790 | $0 | $15,950 | $0 | $30,149 | $0 | $369,655 | $0 | $0 |
| PAWLIK RN COLLEEN | ||||||||||||||
| INTERIM CNO BOLING/GLEN (BEG 4/21) | $0 | $212,088 | $0 | $41,694 | $0 | $17,694 | $0 | $5,558 | $0 | $26,408 | $0 | $303,442 | $0 | $0 |
| BROWN JARED | ||||||||||||||
| SR. DIR. FINANCE-BOLINGBRO | $0 | $194,433 | $0 | $40,716 | $0 | $8,225 | $0 | $15,730 | $0 | $16,371 | $0 | $275,475 | $0 | $0 |
| CRUZ RN OBED | ||||||||||||||
| VP/CNO BOLINGBROOK (END 4/21) | $0 | $72,702 | $0 | $0 | $0 | $161,022 | $0 | $1,133 | $0 | $9,144 | $0 | $244,001 | $0 | $0 |
| PAMINTUAN JAY | ||||||||||||||
| RN-CHARGE | $87,234 | $0 | $13,672 | $0 | $91,423 | $0 | $9,094 | $0 | $25,494 | $0 | $226,917 | $0 | $0 | $0 |
| DE RAMOS DO DAVID | ||||||||||||||
| DIRECTOR | $0 | $128,341 | $0 | $0 | $0 | $65,343 | $0 | $11,297 | $0 | $17,550 | $0 | $222,531 | $0 | $0 |
| LEONARD DIANE | ||||||||||||||
| RN DIR-NURSING | $105,119 | $0 | $22,400 | $0 | $57,488 | $0 | $8,713 | $0 | $18,940 | $0 | $212,660 | $0 | $0 | $0 |
| ALBAUGH JOLENE | ||||||||||||||
| FORMER CNO | $0 | $154,983 | $0 | $15,700 | $0 | $6,642 | $0 | $11,400 | $0 | $8,276 | $0 | $197,001 | $0 | $0 |
| SADURSKI AGNES | ||||||||||||||
| RN EMERGENCY DEPT | $85,492 | $0 | $18,367 | $0 | $52,022 | $0 | $9,071 | $0 | $271 | $0 | $165,223 | $0 | $0 | $0 |
| PONTERIO JODI | ||||||||||||||
| MGR-PHARMACY | $153,938 | $0 | $0 | $0 | $126 | $0 | $10,006 | $0 | $501 | $0 | $164,571 | $0 | $0 | $0 |
| MICHALOWICZ CATHERINE | ||||||||||||||
| RN MGR-OPERATING ROOM | $110,641 | $0 | $0 | $0 | $48,008 | $0 | $5,128 | $0 | $369 | $0 | $164,146 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF THE FILING ORGANIZATION'S PARENT. THE FILING ORGANIZATION AND ITS 501(C)(3) PARENT ARE PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE TOP-TIER PARENT OF ADVENTHEALTH IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AS PART OF ADVENTHEALTH, THE FILING ORGANIZATION ADHERES TO CERTAIN AHSSHC POLICIES REGARDING ITS EXECUTIVES. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: NOMINAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING ($300 OR LESS PER EXECUTIVE). PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. |
| PART I, LINE 3 | THE FILING ORGANIZATION IS A COVERED AFFILIATE OF THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. D/B/A AMITA HEALTH (AMITA). AMITA UTILIZES VARIOUS COMPARABILITY DATA IN ESTABLISHING COMPENSATION FOR THOSE EXECUTIVES THAT PERFORM SERVICES FOR AMITA AND FOR ONE OR MORE COVERED AFFILIATES. COMPARABILITY DATA UTILIZED INCLUDES COMPENSATION SURVEYS AND STUDIES AND THE FORMS 990 OF OTHER UNRELATED COMPARABLE ORGANIZATIONS. AMITA ALSO HAS A COMPENSATION COMMITTEE THAT APPROVES ALL RELEVANT EXECUTIVE COMPENSATION. THE COMPENSATION OF THE FILING ORGANIZATION'S CEO WAS DETERMINED AND APPROVED BY AMITA'S EXECUTIVE COMPENSATION COMMITTEE. |
| PART I, LINES 4A-B | LINE 4A: DURING THE YEAR ENDING DECEMBER 31, 2021, OBED CRUZ, CNO AND DIANE LEONARD, OB NURSING DIRECTOR RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $147,590 AND $52,356 RESPECTIVELY. PURSUANT TO THE AHSSHC CORPORATE EXECUTIVE POLICY GOVERNING EXECUTIVE SEVERANCE, SEVERANCE AGREEMENTS FOR EXECUTIVES OPERATING AT THE VICE PRESIDENT LEVEL AND ABOVE ARE ENTERED INTO UPON ELIGIBILITY TO FACILITATE THE TRANSITION TO SUBSEQUENT EMPLOYMENT FOLLOWING AN INVOLUNTARY SEPARATION FROM EMPLOYMENT WITH ADVENTHEALTH. OTHER SEVERANCE PAYMENTS MAY BE MADE TO NON-EXECUTIVE PERSONNEL IN CERTAIN CIRCUMSTANCES. LINE 4B: MICHAEL MURRILL, RANDALL HAFFNER, KENNETH BACON, RICHARD CARROLL, MD, AND BRENT SNYDER RECEIVED COMPENSATION IN 2021 FROM ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE TOP-TIER PARENT OF THE FILING ORGANIZATION AND THE PARENT ORGANIZATION OF A HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE BENEFIT PLANS TO ELIGIBLE EXECUTIVES. IN 2020, ADVENTHEALTH RESTRUCTURED ITS EXECUTIVE SUPPLEMENTAL RETIREMENT AND BENEFIT PLANS TO REDUCE COMPLEXITY, TO INCREASE PREDICTABILITY OF BENEFITS AND TO CONSOLIDATE MULTIPLE SUPPLEMENTAL EXECUTIVE BENEFIT PLANS INTO ONE PLAN. EFFECTIVE 1/1/2020, A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP III) WAS ADOPTED AND THE THREE EXISTING PLANS, DESCRIBED BELOW, WERE AMENDED AND RESTATED. THE NEWLY ADOPTED SERP III PLAN, AS WELL AS THE AMENDED AND RESTATED PLANS, WERE REVIEWED AND APPROVED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. SERP III PLAN (EFFECTIVE 1/1/2020): TO RECOGNIZE THE CONTRIBUTION EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH AND TO RECOGNIZE THE LIMITATIONS AVAILABLE TO EXECUTIVES IN QUALIFIED RETIREMENT PLANS DUE TO COMPENSATION LIMITS SET ON SUCH PLANS, ADVENTHEALTH ADOPTED A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP III) IN 2020. THE SERP III PLAN EFFECTIVELY REPLACES THE PRIOR SERP II PLAN, THE EXECUTIVE FLEX BENEFIT PROGRAM PLAN, AND THE SENIOR EXECUTIVE DEATH BENEFIT PLAN FOR QUALIFIED EXECUTIVES EXCEPT FOR CERTAIN GRANDFATHERED EXECUTIVE EMPLOYEES. THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $290,000 IN 2021 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN (AMENDED AND RESTATED IN 2020): IN 2020, THE SERP II PLAN WAS AMENDED AND RESTATED TO PROVIDE THAT ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER. 31, 2027. THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN (AMENDED AND RESTATED IN 2020): IN 2020, THE FLEX PLAN WAS AMENDED AND RESTATED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. ADDITIONALLY, A PROVISION WAS ADDED TO PLACE A MAXIMUM LIMIT ON THE AMOUNT OF A PARTICIPANT'S ANNUAL FLEX ALLOWANCE TO NOT BE GREATER THAN A MAXIMUM DOLLAR AMOUNT OR PERCENTAGE OF COMPENSATION AS ESTABLISHED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE IS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR. |
| SCHEDULE J, PART I, LINE 4B CONTINUATION: | THE SEDB PLAN WAS ORIGINALLY DESIGNED TO PROVIDE A BENEFIT IN AN AMOUNT EQUAL TO THE AMOUNT THE EXECUTIVE'S BENEFIT WOULD HAVE BEEN UNDER THE SERP II PLAN ASSUMING THAT, ON THE DATE OF THE EXECUTIVE'S DEATH (AND NOT BEFORE), THE EXECUTIVE SATISFIED THE LAST OF THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN WITH PRESENT VALUE RECOGNIZING AN EARLY BENEFIT COMMENCEMENT. IN CONJUNCTION WITH THE AMENDMENT AND RESTATEMENT OF THE SERP II PLAN, THE SEDB WAS SIMILARLY AMENDED IN 2020 TO LIMIT ELIGIBLE EMPLOYEES TO ONLY THOSE WHO EITHER SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II AS OF JANUARY 1 2020, OR REMAIN IN ACTIVE EMPLOYMENT AND WILL SATISFY THOSE REQUIREMENTS PRIOR TO DECEMBER 31, 2027. AN ELIGIBLE EXECUTIVE BECOMES A PARTICIPANT IN THE SEDB PLAN IF THE EXECUTIVE DIES PRIOR TO TERMINATION OF EMPLOYMENT, PROVIDED THE EXECUTIVE HAS NOT SATISFIED ALL THE ELIGIBILITY REQUIREMENTS OF SERP II AS OF THE EXECUTIVE'S DATE OF DEATH BUT WOULD HAVE SATISFIED ALL THOSE REQUIREMENTS WITHIN FIVE (5) YEARS FOLLOWING DEATH HAD THE EXECUTIVE LIVED AND CONTINUED EMPLOYMENT. THE SEDB PLAN WILL TERMINATE AUTOMATICALLY AFTER DECEMBER 31, 2027. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. RANDALL HAFFNER, PHD $ 150,000 $ 304,926 $ 829,185 $ 0 RICHARD CARROLL, MD $ 0 $ 0 $ 135,352 $ 0 BRENT SNYDER $ 150,000 $ 444,551 $ 0 $ 0 MICHAEL MURRILL $ 0 $ 0 $ 0 $ 107,423 KENNETH BACON $ 0 $ 0 $ 0 $ 153,462 * INCLUDING INVESTMENT EARNINGS HERBERT BUCHANAN WAS COMPENSATED BY ALEXIAN BROTHERS HEALTH SYSTEM IN 2021 FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. ALEXIAN BROTHERS HEALTH SYSTEM IS AFFILIATED WITH THE FILING ORGANIZATION. PLEASE SEE OUR RESPONSE TO FORM 990, PART VI, SECTION A, LINE 7B FOR A DISCUSSION CONCERNING THE FILING ORGANIZATION'S AFFILIATION WITH ALEXIAN BROTHERS HEALTH SYSTEM THROUGH THE JOINT OPERATING COMPANY KNOWN AS AMITA HEALTH. COMPENSATION FOR THESE INDIVIDUAL'S SERVICES PROVIDED TO THE FILING ORGANIZATION IS DISCLOSED IN PART VII, LINE 1A, AND SCHEDULE J, PART II. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 1A: | THE PARENT CORPORATION OF ADVENTIST BOLINGBROOK HOSPITAL (THE FILING ORGANIZATION) IS ADVENTIST MIDWEST HEALTH (AMH). AMH IS AN ILLINOIS, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). AMH HAS ESTABLISHED A SHARED SERVICE CENTER TO CENTRALIZE THE ACCOUNTS PAYABLE (A/P) FUNCTION FOR ALL AMH SUBSIDIARY ORGANIZATIONS. THE FILING ORGANIZATION HAS ENTERED "0" IN PART V, LINE 1A BECAUSE THE FILING ORGANIZATION NO LONGER ISSUES FORM 1099 RETURNS, RATHER, ALL SUCH RETURNS ARE FILED BY AND UNDER THE NAME AND EIN OF AMH AS THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. THE FACTS AND CIRCUMSTANCES SUPPORT A POSITION THAT AMH, AS A PAYOR ON BEHALF OF ITS SUBSIDIARY ORGANIZATIONS IN A SHARED SERVICE ENVIRONMENT, WILL HAVE SUFFICIENT MANAGEMENT AND OVERSIGHT IN CONNECTION WITH THE SUBSIDIARY ORGANIZATIONS' PAYMENTS TO MEET THE STANDARD SET FORTH IN TREAS. REG. SECTION 1.6041-1(E). AMH WILL NOT MERELY BE MAKING PAYMENTS AT THE DIRECTION OF ITS SUBSIDIARY ORGANIZATIONS. ACCORDINGLY, AMH IS CONSIDERED THE PAYOR SUBJECT TO THE INFORMATION REPORTING REQUIREMENTS OF SECTION 6041. |
| FORM 990, PART VI, SECTION A, LINE 6 | ADVENTIST BOLINGBROOK HOSPITAL (THE FILING ORGANIZATION) HAS ONE MEMBER. THE SOLE MEMBER OF THE FILING ORGANIZATION IS ADVENTIST MIDWEST HEALTH. ADVENTIST MIDWEST HEALTH (AMH) IS AN ILLINOIS, NOT-FOR-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THERE ARE NO OTHER CLASSES OF MEMBERSHIP IN THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS OF THE BOARD OF DIRECTORS (GOVERNING BOARD) OF THE FILING ORGANIZATION ARE APPOINTED BY THE CORPORATE MEMBER, AMH. THE CORPORATE MEMBER IS ENTITLED TO ELECT NOT LESS THAN EIGHTEEN (18) AND NO MORE THAN TWENTY THREE (23) VOTING MEMBERS TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION PURSUANT TO THE PROVISIONS OF THE BYLAWS, SUBJECT TO THE RATIFICATION OF THE AMITA HEALTH BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FILING ORGANIZATION IS A COVERED AFFILIATE OF THE JOC KNOWN AS AMITA HEALTH. THE SOLE MEMBER OF THE FILING ORGANIZATION IS AMH. AMH IS ALSO ONE OF TWO MEMBERS IN AMITA HEALTH. THE OTHER MEMBER OF AMITA HEALTH IS ALEXIAN BROTHERS HEALTH SYSTEM. THE TOP-TIER PARENT OF AMH IS AHSSHC (SPONSOR). THE GOVERNING DOCUMENTS OF THE FILING ORGANIZATION PROVIDE FOR CERTAIN RESERVED POWERS TO EXERCISE FINANCIAL, MANAGERIAL, AND OPERATIONAL AUTHORITIES OVER THE FILING ORGANIZATION BY AHSSHC, AS SPONSOR, BY AMH AS MEMBER, BY BOTH MEMBERS OF THE JOC, NAMELY, AMH AND ALEXIAN BROTHERS HEALTH SYSTEM (MEMBERS), AND BY THE BOARD OF DIRECTORS OF THE JOC. CERTAIN GOVERNANCE POWERS ARE RESERVED TO AMH AS THE MEMBER OF THE FILING ORGANIZATION. THESE RESERVED POWERS INCLUDE THE ALTERATION, RESTATEMENT OR REPEAL OF THE ARTICLES OF INCORPORATION, BYLAWS OR MISSION STATEMENT OF THE FILING ORGANIZATION, PROVIDED THAT SUCH ACTIONS ARE NOT INCONSISTENT WITH THE JOC BYLAWS OR THE AFFILIATION AGREEMENT AND THE APPOINTMENT OF THE FILING ORGANIZATION'S BOARD OF DIRECTORS, SUBJECT TO THE RATIFICATION OF THE JOC BOARD OF DIRECTORS. FINANCIAL AUTHORITIES RESERVED TO THE SPONSOR, THE BOARD OF DIRECTORS OF THE JOC, AND BY BOTH MEMBERS OF THE JOC INCLUDE THE APPROVAL OF ANY DISPOSITION OF THE FILING ORGANIZATION'S ASSETS AND ANY INTERNAL TRANSFER OF THE FILING ORGANIZATION'S ASSETS. THE SPONSOR, THE BOARD OF DIRECTORS OF THE JOC, AND BOTH MEMBERS OF THE JOC MAY APPROVE SUCH DISPOSITIONS OR TRANSFERS UP TO ESTABLISHED ASSET DOLLAR VALUES AS SET FORTH IN THE BYLAWS OF THE FILING ORGANIZATION. ANNUAL OPERATING AND CAPITAL BUDGETS OF THE FILING ORGANIZATION MUST BE RATIFIED BY BOTH SPONSORS OF THE JOC. THE BOARD OF DIRECTORS OF THE JOC MUST APPROVE ANY CAPITAL EXPENDITURE TO BE MADE BY THE FILING ORGANIZATION IN EXCESS OF $10 MILLION. OPERATIONAL AUTHORITIES RESERVED TO THE BOARD OF DIRECTORS OF THE JOC INCLUDE THE DETERMINATION OF THE SERVICES TO BE PROVIDED BY THE FILING ORGANIZATION, INCLUDING THE AUTHORITY TO DIRECT THE EXPANSION, REDUCTION AND CONSOLIDATION OF CLINICAL PROGRAMS, PATIENT CARE SERVICES AND ADMINISTRATIVE CAPABILITIES OR OTHER MAJOR CHANGES IN THE OPERATION OF THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FILING ORGANIZATION'S CURRENT YEAR FORM 990 WAS REVIEWED BY THE BOARD CHAIRMAN, CEO AND BY THE SR. FINANCE DIRECTOR PRIOR TO ITS FILING WITH THE IRS. THE REVIEW CONDUCTED BY THE BOARD CHAIRMAN, CEO AND THE SR. FINANCE DIRECTOR DID NOT INCLUDE THE REVIEW OF ANY SUPPORTING WORKPAPERS THAT WERE USED IN PREPARATION OF THE CURRENT YEAR FORM 990, BUT DID INCLUDE A REVIEW OF THE ENTIRE FORM 990 AND ALL SUPPORTING SCHEDULES. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY OF THE FILING ORGANIZATION APPLIES TO MEMBERS OF ITS BOARD OF DIRECTORS AND ITS PRINCIPAL OFFICERS (TO BE KNOWN AS INTERESTED PERSONS). IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR ANY PRINCIPAL OFFICER OF THE FILING ORGANIZATION (I.E. INTERESTED PERSONS) MUST DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST WITH THE FILING ORGANIZATION AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS CONCERNING THE FINANCIAL INTEREST/ARRANGEMENT TO THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION OR TO ANY MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS THAT IS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. SUBSEQUENT TO ANY DISCLOSURE OF ANY FINANCIAL INTEREST/ARRANGEMENT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE RELEVANT BOARD MEMBER OR PRINCIPAL OFFICER, THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS OR COMMITTEE WITH BOARD DELEGATED POWERS SHALL DISCUSS, ANALYZE, AND VOTE UPON THE POTENTIAL FINANCIAL INTEREST/ARRANGEMENT TO DETERMINE IF A CONFLICT OF INTEREST EXISTS. ACCORDING TO THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OF DIRECTORS (OR COMMITTEE WITH BOARD DELEGATED POWERS), BUT AFTER SUCH PRESENTATION, SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN A CONFLICT OF INTEREST. EACH INTERESTED PERSON, AS DEFINED UNDER THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE FILING ORGANIZATION IS A CHARITABLE ORGANIZATION THAT MUST PRIMARILY ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES. THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT PERIODIC REVIEWS SHALL BE CONDUCTED TO ENSURE THAT THE FILING ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FILING ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES ARE NOT COMPENSATED BY THE FILING ORGANIZATION. THE COMPENSATION PACKAGE FOR THESE INDIVIDUALS IS DETERMINED BY THE JOINT OPERATING COMPANY, ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO. DBA AMITA HEALTH. AS NOTED IN OUR RESPONSE TO PART VI, SECTION A, LINE 7B, THE FILING ORGANIZATION IS A COVERED AFFILIATE OF THE JOC KNOWN AS AMITA HEALTH. THE COMPENSATION OF THE CEO, CFO, COO, CMO AND CNO ARE ESTABLISHED AND APPROVED BY AMITA HEALTH. PLEASE SEE THE DISCUSSION CONCERNING THE PROCESS FOLLOWED BY AMITA HEALTH IN DETERMINING EXECUTIVE COMPENSATION IN OUR RESPONSE TO SCHEDULE J, LINE 3. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF ADVENTHEALTH AND OF THE ADVENTHEALTH "OBLIGATED GROUP" ARE FILED ANNUALLY WITH THE MUNICIPAL SECURITIES RULEMAKING BOARD (MSRB). THE "OBLIGATED GROUP" IS A GROUP OF AHSSHC SUBSIDIARIES THAT ARE JOINTLY AND SEVERALLY LIABLE UNDER A MASTER TRUST INDENTURE THAT SECURES DEBT PRIMARILY ISSUED ON A TAX-EXEMPT BASIS. UNAUDITED QUARTERLY FINANCIAL STATEMENTS PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) ARE ALSO FILED WITH MSRB FOR ADVENTHEALTH ON A CONSOLIDATED BASIS AND FOR THE GROUPING OF ADVENTHEALTH SUBSIDIARIES COMPRISING THE "OBLIGATED GROUP". THE FILING ORGANIZATION DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. |
| PART VII, SECTION A | FOR THOSE BOARD OF DIRECTOR MEMBERS (NOT INCLUDING PHYSICIAN MEMBERS OF THE BOARD), OFFICER(S) AND KEY EMPLOYEES WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN COLUMN (B) ON PAGE 7 OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) ON PAGE 7 WERE PROVIDED IN CONJUNCTION WITH THAT PERSON'S RESPONSIBILITIES AND ROLES IN SERVING IN AN EXECUTIVE LEADERSHIP POSITION WITHIN ADVENTHEALTH OR AMITA HEALTH. PHYSICIAN MEMBERS OF THE BOARD OF DIRECTORS RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS AS A RESULT OF PROVIDING VARIOUS MEDICAL SERVICES TO THOSE RELATED ENTITIES. |
| PART VIII, LINES 7A, B AND C: | THE AMOUNT SHOWN IN PART VIII, LINE 7C(I) OF THE FORM 990 REPRESENTS AN ALLOCATED SHARE OF CAPITAL GAIN/(LOSS) FROM A SYSTEM WIDE, CORPORATE ADMINISTERED, INVESTMENT PROGRAM. |
| FORM 990, PART IX, LINE 11G | PAYMENTS TO HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 7,815,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,815,000. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 12,119,358. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,119,358. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 7,553,699. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,553,699. ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 2,899,509. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,899,509. RECRUITING: PROGRAM SERVICE EXPENSES 9,650. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,650. FOOD SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 2,729,256. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,729,256. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 9,697,400. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,697,400. AHS MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 22,056. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,056. BILLING & COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 7,070,588. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,070,588. REGION SUPPORT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 5,288,686. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,288,686. |
| FORM 990, PART X, LINE 2 | THE AMOUNTS SHOWN ON LINE 2 OF PART X OF THIS RETURN INCLUDE THE FILING ORGANIZATION'S INTEREST IN A CENTRAL INVESTMENT POOL MAINTAINED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION, THE FILING ORGANIZATION'S TOP-TIER PARENT. THE INVESTMENTS IN THE CENTRAL INVESTMENT POOL ARE RECORDED AT MARKET VALUE. |
| FORM 990, PART XI, LINE 9: | TRANSFER TO TOP-TIER TAX-EXEMPT PARENT -3,274,222. NET CHANGE IN INTEREST IN FOUNDATION -80,688. NET FUNDS RELEASED FROM RESTRICTED 44,630. ROUNDING -3. |
| FORM 990, PART XII, LINE 3B | THE TAXPAYER IS PART OF A CONTROLLED GROUP OF ORGANIZATIONS THAT COMPRISE A CONSOLIDATED FINANCIAL STATEMENT AUDIT. THE CONTROLLED GROUP'S PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), A 501(C)(3) ORGANIZATION. THE SYSTEM OF HEALTHCARE ENTITIES OWNED AND CONTROLLED BY AHSSHC IS KNOWN AS ADVENTHEALTH. FOR THE YEAR ENDED DECEMBER 31, 2021, ADVENTHEALTH WILL FILE A CONSOLIDATED SINGLE AUDIT WHICH WILL INCLUDE ALL ENTITIES THAT ARE PART OF THE CONTROLLED GROUP. ACCORDINGLY, THE TAXPAYER HAS CHECKED YES TO THE QUESTIONS ON PART XII, LINE 3A AND 3B. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (103 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ADVENTHEALTH EAST FLORIDA INC (3521 - 123121) | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 882288563 | FUTURE OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTHEALTH FAMILY MEDICINE RURAL HEALTH CLINICS INC | |||||||||||
| 187 PR 4060 | LAMPASAS | TX | 76550 | 271858033 | OPERATION OF RURAL HEALTH CLINICS & MEDICAL SERVICES | FL | 501(C)(3) | LINE 3 | METROPLEX ADVENTIST HOSPITAL INC | Yes (1) | |
| ADVENTHEALTH KANSAS CITY FOUNDATION FKA AH FDN SHAWNEE MISSION | |||||||||||
| 7315 E FRONTAGE ROAD | MERRIAM | KS | 66204 | 480868859 | FUND-RAISING FOR TAX-EXEMPT HOSPITALS | KS | 501(C)(3) | LINE 7 | SHAWNEE MISSION MEDICAL CENTER INC | Yes (1) | |
| ADVENTHEALTH HOME CARE EAST FLORIDA LLC | |||||||||||
| 770 WEST GRANADA BLVD 319 | ORMOND BEACH | FL | 32174 | 833768458 | INACTIVE | FL | 501(C)(3) | LINE 10 | MEMORIAL HLTH SYSTEMS INC | Yes (1) | |
| ADVENTHEALTH HOSPICE CARE EAST FLORIDA INC | |||||||||||
| 770 WEST GRANADA BLVD 304 | ORMOND BEACH | FL | 32174 | 833748461 | INACTIVE | FL | 501(C)(3) | LINE 10 | MEMORIAL HLTH SYSTEMS INC | Yes (1) | |
| ADVENTHEALTH NORTH POLK INC | |||||||||||
| 3100 E FLETCHER AVE | TAMPA | FL | 33613 | 593231322 | INACTIVE | FL | 501(C)(3) | LINE 12A, I | UNIVERSITY COMMUNITY HOSPITAL INC | Yes (1) | |
| ADVENTHEALTH POLK NORTH INC | |||||||||||
| 40100 US HIGHWAY 27 N | DAVENPORT | FL | 33837 | 841793121 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTHEALTH POLK SOUTH INC | |||||||||||
| 410 SOUTH 11TH STREET | LAKE WALES | FL | 33853 | 834672945 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTHEALTH RANSOM MEMORIAL INC | |||||||||||
| 1301 S MAIN STREET | OTTAWA | KS | 66067 | 830976641 | OPERATION OF HOSPITAL & RELATED SERVICES | KS | 501(C)(3) | LINE 3 | ADVENTIST HLTH MID-AMERICA INC | Yes (1) | |
| ADVENTHEALTH RIVERVIEW INC (5321 - 123121) | |||||||||||
| 14055 RIVEREDGE DRIVE STE 150 | TAMPA | FL | 33637 | 870901094 | FUTURE OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTHEALTH SENIOR CARE INC | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 841817046 | OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTHEALTH SOUTH OVERLAND PARKINC | |||||||||||
| 7820 W 165TH STREET | OVERLAND PARK | KS | 66223 | 364595806 | OPERATION OF HOSPITAL & RELATED SERVICES | KS | 501(C)(3) | LINE 3 | ADVENTIST HLTH MID-AMERICA INC | Yes (1) | |
| ADVENTHEALTH UNIVERSITY INC | |||||||||||
| 671 WINYAH DRIVE | ORLANDO | FL | 32803 | 593069793 | EDUCATION/OPERATION OF SCHOOL | FL | 501(C)(3) | LINE 2 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC | |||||||||||
| 14055 RIVEREDGE DRIVE STE 250 | TAMPA | FL | 33637 | 471881744 | SUPPORT OF IMAGING CENTER & HOME HEALTH SUBSIDIARIES | FL | 501(C)(3) | LINE 12B, II | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTHEALTH WEST FLORIDA IMAGING INC | |||||||||||
| 14055 RIVEREDGE DRIVE STE 250 | TAMPA | FL | 33637 | 843225135 | IMAGING & TESTING | FL | 501(C)(3) | LINE 3 | ADVENTHEALTH WEST FLORIDA AMBULATORY SERVICES INC | Yes (1) | |
| ADVENTIST BOLINGBROOK HOSPITAL | |||||||||||
| 500 REMINGTON BLVD | BOLINGBROOK | IL | 60440 | 651219504 | OPERATION OF HOSPITAL & RELATED SERVICES | IL | 501(C)(3) | LINE 3 | ADVENTIST MIDWEST HEALTH | Yes (1) | |
| ADVENTIST CARE CENTERS - COURTLAND INC | |||||||||||
| 730 COURTLAND STREET | ORLANDO | FL | 32804 | 205774723 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| ADVENTIST GLENOAKS HOSPITAL | |||||||||||
| 701 WINTHROP AVENUE | GLENDALE HEIGHTS | IL | 60139 | 363208390 | OPERATION OF HOSPITAL & RELATED SERVICES | IL | 501(C)(3) | LINE 3 | ADVENTIST MIDWEST HEALTH | Yes (1) | |
| ADVENTIST HEALTH MID-AMERICA INC | |||||||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 521347407 | SUPPORT OF AFFILIATED HOSPITAL | KS | 501(C)(3) | LINE 12C, III-FI | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| ADVENTIST HEALTH PARTNERS INC | |||||||||||
| 5101 S WILLOW SPRINGS RD SUITE B101 | LA GRANGE | IL | 60525 | 364138353 | OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES | IL | 501(C)(3) | LINE 3 | AHS MIDWEST MANAGEMENT INC | Yes (1) | |
| ADVENTIST HEALTH SYSTEM GEORGIA INC | |||||||||||
| 1035 RED BUD ROAD NE | CALHOUN | GA | 30701 | 581425000 | OPERATION OF HOSPITAL & RELATED SERVICES | GA | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 592170012 | MANAGEMENT SERVICES | FL | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| ADVENTIST HLTH SYSTEMSUNBELT INC | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 591479658 | OPERATION OF HOSPITALS & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTIST HLTH SYSTEMTEXAS INC | |||||||||||
| 11801 S FREEWAY | BURLESON | TX | 76028 | 742578952 | LEASING PERSONNEL TO AFFILIATED HOSPITAL | TX | 501(C)(3) | LINE 12C, III-FI | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| ADVENTIST MIDWEST HEALTH | |||||||||||
| 120 NORTH OAK STREET | HINSDALE | IL | 60521 | 362276984 | OPERATION OF HOSPITALS & RELATED SERVICES | IL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| AHP SPECIALTY CARE NFP | |||||||||||
| 5101 S WILLOW SPRINGS RD SUITE B101 | LA GRANGE | IL | 60525 | 811105774 | OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES | IL | 501(C)(3) | LINE 3 | AHS MIDWEST MANAGEMENT INC | Yes (1) | |
| AHS MIDWEST MANAGEMENT INC | |||||||||||
| 5101 S WILLOW SPRINGS RD SUITE B101 | LA GRANGE | IL | 60525 | 363354567 | OPERATION OF PHYSICIAN PRACTICE MANAGEMENT | IL | 501(C)(3) | LINE 12A, I | ADVENTIST MIDWEST HEALTH | Yes (1) | |
| ALEXIAN BROTHERS-AHS MIDWEST REGION HEALTH CO DBA AMITA HEALTH | |||||||||||
| 2601 NAVISTAR DR BLDG 4 FINANCE | LISLE | IL | 60532 | 472360513 | JOINT OPERATING COMPANY | IL | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| APOPKA HEALTH CARE PROPERTIES INC | |||||||||||
| 305 E OAK STREET | APOPKA | FL | 32703 | 510605694 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| BERT FISH MEDICAL CENTER AUXILIARY INC | |||||||||||
| 401 PALMETTO STREET | NEW SMYRNA BEACH | FL | 32168 | 591054892 | VOLUNTEER SUPPORT SERVICES | FL | 501(C)(3) | LINE 10 | 0 | N/A | |
| BRADFORD HEIGHTS HEALTH & REHAB CENTER INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 205782342 | INACTIVE - WIND-DOWN | KY | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| BURLESON NURSING & REHAB CENTER INC | |||||||||||
| 301 HUGULEY BLVD | BURLESON | TX | 76028 | 205782243 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | TX | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| CHICKASAW HEALTH CARE PROPERTIES INC | |||||||||||
| 250 S CHICKASAW TRAIL | ORLANDO | FL | 32825 | 510605681 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| CHIPPEWA VALLEY HOSPITAL & OAKVIEW CARE CENTER INC | |||||||||||
| 1220 THIRD AVENUE WEST | DURAND | WI | 54736 | 391365168 | OPERATION OF HOSPITAL & RELATED SERVICES | WI | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| COALITION FOR PHYSICIAN WELL-BEING INC | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 463477012 | PROVIDE SUPPORT FOR PHYSICIAN WELL-BEING | FL | 501(C)(3) | LINE 10 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| COURTLAND HEALTH CARE PROPERTIES INC | |||||||||||
| 730 COURTLAND STREET | ORLANDO | FL | 32804 | 510605682 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| CREEKWOOD PLACE NURSING & REHAB CENTER INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 205782260 | INACTIVE - WIND-DOWN | KY | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| DAIRY ROAD HEALTH CARE PROPERTIES INC | |||||||||||
| 7350 DAIRY ROAD | ZEPHYRHILLS | FL | 33540 | 510605684 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| EAST ORLANDO HEALTH & REHAB CENTER INC | |||||||||||
| 250 S CHICKASAW TRAIL | ORLANDO | FL | 32825 | 205774748 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| EMORY-ADVENTIST INC (1121 - 123121) | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 582171011 | INACTIVE | GA | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| FLETCHER HOSPITAL INC | |||||||||||
| 100 HOSPITAL DRIVE | HENDERSONVILLE | NC | 28792 | 560543246 | OPERATION OF HOSPITAL & RELATED SERVICES | NC | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| FLNC INC | |||||||||||
| 3355 E SEMORAN BLVD | APOPKA | FL | 32703 | 205774761 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| FLORIDA HOSPITAL DADE CITY INC | |||||||||||
| 13100 FORT KING ROAD | DADE CITY | FL | 33525 | 822567308 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| FLORIDA HOSPITAL HEALTHCARE PARTNERS INC | |||||||||||
| 770 WEST GRANADA BLVD 101 | ORMOND BEACH | FL | 32174 | 462354804 | OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| FLORIDA HOSPITAL MEDICAL GROUP INC | |||||||||||
| 2600 WESTHALL LANE 4TH FLOOR | MAITLAND | FL | 32751 | 593214635 | OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| FLORIDA HOSPITAL OCALA INC | |||||||||||
| 1500 SW 1ST AVENUE | OCALA | FL | 34471 | 824372339 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| FLORIDA HOSPITAL PHYSICIAN GROUP INC | |||||||||||
| 12470 TELECOM DR 100 | TAMPA | FL | 33637 | 462021581 | OPERATION OF PHYSICIAN PRACTICES & MEDICAL SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| FLORIDA HOSPITAL WATERMAN INC | |||||||||||
| 1000 WATERMAN WAY | TAVARES | FL | 32778 | 593140669 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| FLORIDA HOSPITAL ZEPHYRHILLS INC | |||||||||||
| 7050 GALL BLVD | ZEPHYRHILLS | FL | 33541 | 592108057 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC | |||||||||||
| 2600 WESTHALL LANE 4TH FLOOR | MAITLAND | FL | 32751 | 550789387 | IMAGING & TESTING | FL | 501(C)(3) | LINE 3 | FLORIDA HOSPITAL MEDICAL GROUP INC | Yes (1) | |
| FOUNTAIN INN NURSING & REHAB CENTER INC | |||||||||||
| 4501 WATERMAN WAY | TAVARES | FL | 32778 | 472180518 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| HELEN ELLIS MEMORIAL HOSPITAL AUXILIARY INC | |||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 592106043 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL/FOUNDATION | FL | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |
| HELEN ELLIS MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 593690149 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | FL | 501(C)(3) | LINE 7 | 0 | N/A | |
| HINSDALE HOSPITAL FOUNDATION | |||||||||||
| 120 NORTH OAK STREET | HINSDALE | IL | 60521 | 521466387 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | IL | 501(C)(3) | LINE 7 | MIDWEST HLTH FOUNDATION | 0 | |
| HOSPICE OF THE COMFORTER INC | |||||||||||
| 480 W CENTRAL PARKWAY | ALTAMONTE SPRINGS | FL | 32714 | 592935928 | OPERATION OF HOSPICE | FL | 501(C)(3) | LINE 10 | THE COMFORTER HEALTH CARE GROUP INC | Yes (1) | |
| IN-MOTION REHAB INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 208023411 | INACTIVE | KS | 501(C)(3) | LINE 12B, II | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| LAKE COUNTY HEALTH CARE PROPERTIES INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 813923985 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| MEMORIAL HEALTH SYSTEMS FOUNDATION INC | |||||||||||
| 305 MEMORIAL MEDICAL PKWY 212 | DAYTONA BEACH | FL | 32117 | 311771522 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | FL | 501(C)(3) | LINE 7 | 0 | N/A | |
| MEMORIAL HEALTH SYSTEMS INC | |||||||||||
| 301 MEMORIAL MEDICAL PARKWAY | DAYTONA BEACH | FL | 32117 | 590973502 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| MEMORIAL HOSPITAL - WEST VOLUSIA INC | |||||||||||
| 701 WEST PLYMOUTH AVENUE | DELAND | FL | 32720 | 593256803 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | MEMORIAL HLTH SYSTEMS INC | Yes (1) | |
| MEMORIAL HOSPITAL FLAGLER INC | |||||||||||
| 60 MEMORIAL MEDICAL PARKWAY | PALM COAST | FL | 32164 | 592951990 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | MEMORIAL HLTH SYSTEMS INC | Yes (1) | |
| MEMORIAL HOSPITAL INC | |||||||||||
| 210 MARIE LANGDON DRIVE | MANCHESTER | KY | 40962 | 610594620 | OPERATION OF HOSPITAL & RELATED SERVICES | KY | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| METROPLEX ADVENTIST HOSPITAL INC | |||||||||||
| 2201 S CLEAR CREEK ROAD | KILLEEN | TX | 76549 | 742225672 | OPERATION OF HOSPITAL & RELATED SERVICES | TX | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| METROPLEX CLINIC PHYSICIANS INC | |||||||||||
| 2201 S CLEAR CREEK ROAD | KILLEEN | TX | 76549 | 113762050 | PHYSICIAN HEALTHCARE SERVICES TO THE COMMUNITY | TX | 501(C)(3) | LINE 3 | METROPLEX ADVENTIST HOSPITAL INC | Yes (1) | |
| MIDWEST HEALTH FOUNDATION | |||||||||||
| 120 NORTH OAK STREET | HINSDALE | IL | 60521 | 352230515 | FUND-RAISING FOR SUPPORTED EXEMPT HOSPITALS | IL | 501(C)(3) | LINE 7 | 0 | N/A | |
| MILLS HEALTH & REHAB CENTER INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 205782320 | INACTIVE - WIND-DOWN | KY | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| MISSION STRATEGIES OF GEORGIA INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 900866024 | PROVISION OF SUPPORT TO THE NURSING HOME DIVISION | GA | 501(C)(3) | LINE 12B, II | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| MISSOURI ADVENTIST HEALTH INC | |||||||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 431224729 | SUPPORT HEALTH CARE SERVICES | MO | 501(C)(3) | LINE 12D, III-O | ADVENTIST HLTH MID-AMERICA INC | Yes (1) | |
| ORMOND BEACH MEMORIAL HOSPITAL AUXILIARY INC(11-123121) | |||||||||||
| 301 MEMORIAL MEDICAL PKWY | DAYTONA BEACH | FL | 32117 | 591721962 | VOLUNTEER SUPPORT SERVICES | FL | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |
| OSCEOLA HEALTH CARE PROPERTIES INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 813165729 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| OVERLAND PARK NURSING & REHAB CENTER INC | |||||||||||
| 6501 WEST 75TH STREET | OVERLAND PARK | KS | 66204 | 205774821 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | KS | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| PASCO-PINELLAS HILLSBOROUGH COMMUNITY HLTH SYSTEM INC | |||||||||||
| 2600 BRUCE B DOWNS BLVD | WESLEY CHAPEL | FL | 33544 | 208488713 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| PORTERCARE ADVENTIST HEALTH SYSTEM (630 YE) | |||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840438224 | OPERATION OF HOSPITALS & RELATED SERVICES | CO | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| PRINCETON HEALTH & REHAB CENTER INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 205782272 | INACTIVE - WIND-DOWN | KY | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| PRINCETON PROFESSIONAL SERVICES INC | |||||||||||
| 601 E ROLLINS STREET | ORLANDO | FL | 32803 | 591191045 | PROVISION OF HEALTHCARE SERVICES | FL | 501(C)(3) | LINE 10 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| QUALITY CIRCLE FOR HEALTHCARE INC | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 263789368 | HEALTHCARE QUALITY SERVICES | FL | 501(C)(3) | LINE 12A, I | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| REDMOND PARK HOSPITAL LLC (10121 - 123121) | |||||||||||
| 501 REDMOND ROAD NW | ROME | GA | 30165 | 581123037 | OPERATION OF HOSPITAL & RELATED SERVICES | GA | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| RESOURCE PERSONNEL INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 208040875 | PROVIDE ADMINISTRATIVE SUPPORT TO TAX EXEMPT NURSING HOMES | FL | 501(C)(3) | LINE 12B, II | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| ROCKY MOUNTAIN ADVENTIST HLTHCARE FOUNDATION (630 YE) | |||||||||||
| 960 E HARVARD AVENUE STE 230 | DENVER | CO | 80210 | 840745018 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | CO | 501(C)(3) | LINE 7 | 0 | N/A | |
| ROLLINS BROOK COMMUNITY CARE CORP | |||||||||||
| 2201 S CLEAR CREEK ROAD | KILLEEN | TX | 76549 | 461656773 | SUPPORT OPERATION OF HOSPITAL | TX | 501(C)(3) | LINE 12A, I | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| SAN MARCOS HEALTH CARE PROPERTIES INC (11 - 123021) | |||||||||||
| 1900 MEDICAL PARKWAY | SAN MARCOS | TX | 78666 | 510605693 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| SAN MARCOS NURSING & REHAB CENTER INC | |||||||||||
| 1900 MEDICAL PARKWAY | SAN MARCOS | TX | 78666 | 205782224 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | TX | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| SHAWNEE MISSION HLTH CARE PROPERTIES INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 813914908 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| SHAWNEE MISSION HEALTH CARE INC | |||||||||||
| 6501 WEST 75TH STREET | OVERLAND PARK | KS | 66204 | 480952508 | LEASE TO RELATED ORGANIZATION | KS | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| SHAWNEE MISSION MEDICAL CENTER INC | |||||||||||
| 9100 W 74TH STREET | SHAWNEE MISSION | KS | 66204 | 480637331 | OPERATION OF HOSPITAL & RELATED SERVICES | KS | 501(C)(3) | LINE 3 | ADVENTIST HLTH MID-AMERICA INC | Yes (1) | |
| SOUTH PASCO HEALTH CARE PROPERTIES INC | |||||||||||
| 38250 A AVENUE | ZEPHYRHILLS | FL | 33542 | 510605679 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| SOUTHEAST VOLUSIA HEALTHCARE CORP | |||||||||||
| 401 PALMETTO STREET | NEW SMYRNA BEACH | FL | 32168 | 473793197 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| SOUTHWEST VOLUSIA HEALTH SERVICES INC | |||||||||||
| 1055 SAXON BLVD | ORANGE CITY | FL | 32763 | 593281591 | MEDICAL OFFICE BUILDING FOR HOSPITAL | FL | 501(C)(3) | LINE 12A, I | SOUTHWEST VOLUSIA HLTHCARE CORP | Yes (1) | |
| SOUTHWEST VOLUSIA HEALTHCARE CORP | |||||||||||
| 1055 SAXON BLVD | ORANGE CITY | FL | 32763 | 593149293 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEMSUNBELT INC | Yes (1) | |
| SPRING VIEW HEALTH & REHAB CENTER INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 205782288 | INACTIVE - WIND-DOWN | KY | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| SUNBELT HEALTH & REHAB CENTER - APOPKA INC | |||||||||||
| 305 EAST OAK STREET | APOPKA | FL | 32703 | 205774856 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| SUNBELT HEALTH CARE CENTERS INC | |||||||||||
| 485 NORTH KELLER ROAD 250 | MAITLAND | FL | 32751 | 581473135 | MANAGEMENT SERVICES | TN | 501(C)(3) | LINE 12B, II | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| SUNSYSTEM DEVELOPMENT CORP | |||||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 592219301 | FUND-RAISING FOR AFFILIATED TAX-EXEMPT HOSPITALS | FL | 501(C)(3) | LINE 7 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| TARPON SPRINGS HOSPITAL FOUNDATION INC | |||||||||||
| 1395 S PINELLAS AVE | TARPON SPRINGS | FL | 34689 | 590898901 | OPERATION OF HOSPITAL & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | UNIVERSITY COMMUNITY HOSPITAL INC | Yes (1) | |
| TARRANT COUNTY HEALTH CARE PROPERTIES INC | |||||||||||
| 301 HUGULEY BLVD | BURLESON | TX | 76028 | 510605677 | LEASE TO RELATED ORGANIZATION | GA | 501(C)(3) | LINE 12C, III-FI | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| THE COMFORTER HEALTH CARE GROUP INC | |||||||||||
| 605 MONTGOMERY ROAD | ALTAMONTE SPRINGS | FL | 32714 | 271857940 | SUPPORT SERVICES TO RELATED HOSPICE | FL | 501(C)(3) | LINE 12C, III-FI | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| THE VOLUNTEER AUXILIARY OF FLORIDA HOSP FLAGLER INC(11-8321) | |||||||||||
| 60 MEMORIAL MEDICAL PKWY | PALM COAST | FL | 32164 | 592486582 | VOLUNTEER SUPPORT SERVICES | FL | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |
| TRI-COUNTY NURSING AND REHAB CENTER INC | |||||||||||
| 1290 CELEBRATION BLVD | KISSIMMEE | FL | 34747 | 472219363 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| UNIVERSITY COMMUNITY HOSPITAL FOUNDATION INC | |||||||||||
| 3100 E FLETCHER AVE | TAMPA | FL | 33613 | 592554889 | FUND-RAISING FOR TAX-EXEMPT HOSPITAL | FL | 501(C)(3) | LINE 7 | 0 | N/A | |
| UNIVERSITY COMMUNITY HOSPITAL INC | |||||||||||
| 3100 E FLETCHER AVE | TAMPA | FL | 33613 | 591113901 | OPERATION OF HOSPITALS & RELATED SERVICES | FL | 501(C)(3) | LINE 3 | ADVENTIST HLTH SYSTEM SUNBELT HLTHCARE CORP | Yes (1) | |
| WEST FLORIDA HEALTH HOME CARE INC | |||||||||||
| 13601 BRUCE B DOWNS BLVD STE 110 | TAMPA | FL | 33613 | 593686109 | HOME HEALTH SERVICES | GA | 501(C)(3) | LINE 10 | ADVENTHEALTH WEST FLORIDA AMBULATORY SVCS INC | Yes (1) | |
| ZEPHYR HAVEN HEALTH & REHAB CENTER INC | |||||||||||
| 38250 A AVENUE | ZEPHYRHILLS | FL | 33542 | 205774930 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
| ZEPHYRHILLS HEALTH & REHAB CENTER INC | |||||||||||
| 7350 DAIRY ROAD | ZEPHYRHILLS | FL | 33540 | 205774967 | OPERATION OF HOME FOR THE AGED/HLTHCARE DELIVERY | FL | 501(C)(3) | LINE 10 | SUNBELT HLTH CARE CENTERS INC | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| FLETCHER HOSPITAL SURGICAL VENTURES LLC | |||||||||
| 9131 ANSON WAY STE 304 | RALEIGH | NC | 27615 | 861482646 | INDIRECT INTEREST IN SURGERY CENTER | NC | N/A | 0 | 0 |
| FLORIDA HOSPITAL DMERT LLC | |||||||||
| 500 WINDERLEY PLACE STE 324 | MAITLAND | FL | 32751 | 202392253 | MEDICAL EQUIPMENT | FL | N/A | 0 | Yes (1) |
| FLORIDA HOSPITAL HOME INFUSION LLP | |||||||||
| 500 WINDERLEY PLACE STE 226 | MAITLAND | FL | 32751 | 593142824 | HOME INFUSION SERVICES | FL | N/A | 0 | Yes (1) |
| FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CTR LLC | |||||||||
| 11 W DRY CREEK CIRCLE 120 | LITTLETON | CO | 80120 | 464426708 | SURGERY CENTER | CO | N/A | 0 | 0 |
| PAHS ONPOINT URGENT CARE LLC | |||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 832465331 | URGENT CARE CENTER | CO | N/A | 0 | 0 |
| PRINCETON HOMECARE SERVICES LLC | |||||||||
| 1050 FORRER BLVD | KETTERING | OH | 45420 | 814196648 | OPERATION OF HOME HEALTH AGENCY | FL | N/A | 0 | 0 |
| SAN MARCOS MRI LP (1121-8121) | |||||||||
| 1330 WONDER WORLD DR STE 202 | SAN MARCOS | TX | 78666 | 770597972 | IMAGING & TESTING | TX | N/A | 0 | 0 |
| SURGERY CENTER OF ROME LP | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 200390305 | SURGERY CENTER | FL | N/A | 0 | 0 |
| THE BARIATRIC CENTER OF KANSAS CITY LLC | |||||||||
| 9100 W 74TH STREET | MERRIAM | KS | 66204 | 823025378 | SURGERY CENTER | KS | N/A | 0 | 0 |
| URGENT CARE CENTERS OF BREVARD COUNTY LLC | |||||||||
| 2600 WESTHALL LANE | MAITLAND | FL | 32751 | 844261523 | URGENT CARE CENTERS | FL | N/A | 0 | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| ADVENTHEALTH ORLANDO NETWORK INC (35 - 123121) | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 862639185 | INACTIVE | FL | N/A | C | Yes (1) |
| ADVENTHEALTH PROFESSIONAL STAFFING INC (35 - 123121) | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 880742779 | INACTIVE | FL | N/A | C | Yes (1) |
| ADVENTHEALTH TAMPA NETWORK INC (35 - 123121) | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 862666178 | INACTIVE | FL | N/A | C | Yes (1) |
| ADVENTHEALTH TEAM MEMBERS INC (35 - 123121) | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 880763664 | INACTIVE | FL | N/A | C | Yes (1) |
| ALTAMONTE MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC | |||||||||
| 601 EAST ROLLINS STREET | ORLANDO | FL | 32803 | 592855792 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| APOPKA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC | |||||||||
| 601 EAST ROLLINS STREET | ORLANDO | FL | 32803 | 593000857 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| BATTLE CREEK ADVENTIST HOSPITAL | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 381359189 | INACTIVE | MI | N/A | C | Yes (1) |
| CENTRAL TEXAS MEDICAL ASSOCIATES (11-12252021) | |||||||||
| 1301 WONDER WORLD DRIVE | SAN MARCOS | TX | 78666 | 742729873 | INACTIVE | TX | N/A | C | Yes (1) |
| FLORIDA HOSPITAL FLAGLER MEDICAL OFFICES ASSOCIATION INC | |||||||||
| 60 MEMORIAL MEDICAL PARKWAY | PALM COAST | FL | 32164 | 262158309 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| FLORIDA HOSP HLTH VILLAGE PROPERTY OWNER'S ASSOC INC | |||||||||
| 550 E ROLLINS STREET 7TH FLOOR | ORLANDO | FL | 32803 | 821748255 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| FLORIDA HOSPITAL HEALTHCARE SYSTEM INC | |||||||||
| 101 SOUTHHALL LANE STE 150 | MAITLAND | FL | 32751 | 593215680 | PHSO / CIN | FL | N/A | C | Yes (1) |
| FLORIDA MEDICAL PLAZA CONDOMINIUM ASSOCIATION INC | |||||||||
| 601 EAST ROLLINS STREET | ORLANDO | FL | 32803 | 592855791 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| KISSIMMEE MULTISPECIALTY CLINIC CONDOMINIUM ASSOCIATION INC | |||||||||
| 201 HILDA STREET SUITE 30 | KISSIMMEE | FL | 34741 | 593539564 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| MIDWEST MANAGEMENT SERVICES INC | |||||||||
| 9100 WEST 74TH STREET | SHAWNEE MISSION | KS | 66204 | 480901551 | INACTIVE | KS | N/A | C | Yes (1) |
| NORTH AMERICAN HEALTH SERVICES INC & SUB | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 621041820 | HOLDING CO. | TN | N/A | C | Yes (1) |
| ORMOND PROF ASSOCIATES CONDO ASSOC INC (430 YEAR END) | |||||||||
| 770 W GRANADA BLVD STE 101 | ORMOND BEACH | FL | 32174 | 592694434 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| PARK RIDGE PROPERTY OWNER'S ASSOCIATION INC | |||||||||
| 1 PARK PLACE NAPLES ROAD | FLETCHER | NC | 28732 | 030380531 | CONDO ASSOCIATION | NC | N/A | C | Yes (1) |
| PORTER AFFILIATED HEALTH SERVICES INC (11-63021) | |||||||||
| 2525 S DOWNING STREET | DENVER | CO | 80210 | 840956175 | INACTIVE | CO | N/A | C | Yes (1) |
| SURGICARE OF ROME INC (10121 - 123121) | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 200376307 | HOLDING COMPANY | GA | N/A | C | Yes (1) |
| REDMOND PARK HEALTH SERVICES INC (10121 - 123121) | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 621330078 | HOLDING COMPANY | GA | N/A | C | Yes (1) |
| REDMOND PHYSICIAN PRACTICE COMPANY (10121 - 10121) | |||||||||
| 900 HOPE WAY | ALTAMONTE SPRINGS | FL | 32714 | 621662134 | MEDICAL CLINICS | GA | N/A | C | Yes (1) |
| THE GARDEN RETIREMENT COMMUNITY INC | |||||||||
| 485 NORTH KELLER ROAD STE 250 | MAITLAND | FL | 32751 | 593414055 | REAL ESTATE RENTAL | FL | N/A | C | Yes (1) |
| WINTER PARK MEDICAL OFFICE BUILDING I CONDO ASSOC INC | |||||||||
| 601 EAST ROLLINS STREET | ORLANDO | FL | 32803 | 452228478 | CONDO ASSOCIATION | FL | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ADVENTIST MIDWEST HEALTH | ||
| P | $88,763,368 | COST |
| ADVENTIST MIDWEST HEALTH | ||
| Q | $9,014,945 | COST |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | ||
| B | $3,274,222 | ACTUAL AMOUNT GIVEN |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | ||
| M | $1,610,817 | % OF FACILITY'S OPERATING EXP. |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION | ||
| P | $3,572,880 | COST |
| ADVENTIST GLEN OAKS HOSPITAL | ||
| Q | $331,246 | COST |
| ADVENTIST HEALTH PARTNERS INC | ||
| P | $3,972,190 | COST |
| ADVENTIST GLEN OAKS HOSPITAL | ||
| P | $390,131 | COST |
| ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORP DBA AH INFO TECHNOLOGY | ||
| M | $6,182,494 | % OF FACILITY'S OPERATING EXP. |
| MIDWEST HEALTH FOUNDATION | ||
| C | $129,703 | ACTUAL AMOUNT TRANSFERRED |
| ADVENTIST HEALTH PARTNERS INC | ||
| Q | $435,272 | COST |